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IPM Innovator Award - Nomination Form

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You can nominate a candidate by filling out and submitting this form. You can make your nomination brief as we will get details from the nominated groups. If you have problems using this form contact Ann Schaffner at (916) 324-4156, fax at (916) 324-9006 or e-mail at aschaffner@cdpr.ca.gov

The deadline for nominations for the 2011 awards is May 31.

Candidate Organization or Group:


1.
 Contact Information   (Please complete all fields)
(a).    Contact person for the Organization:
Name:   
Address:
Telephone:
FAX:
E-mail:
     
(b).   Name of person making nomination. We may want to contact you for more information. Please provide telephone number and email.
Name:
Telephone:
E-mail:
   
2.   Describe how the organization or group demonstrates leadership and creativity in IPM.
 

3.   Describe the organization or groups willingness to share IPM information with others.
 

4.   Why does this organization or group deserve an IPM Innovator Award?
 



For content questions, contact:
IPM Innovators Program
Ann Schaffner
Department of Pesticide Regulation
Pest Management & Licensing Branch
P.O. Box 4015
Sacramento, CA 95812-4015
Telephone: (916) 324-4156
Fax: (916) 324-9006
E-mail: aschaffner@cdpr.ca.gov