IPM Innovator Award - Nomination Form

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

The deadline for 2008 awards is May 30.

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?

Back to IPM Innovators Awards

If you have questions, please contact:

IPM Innovators Program
c/o Bob Elliott
Department of Pesticide Regulation
Pest Management & Licensing Branch
P.O. Box 4015
Sacramento, CA 95812-4015
Phone: (916) 324-4156
Fax: (916) 324-9006
E-mail: