Nomination Form for
Environmental Health and Safety

Certificate of Appreciation

The University of Kentucky would like to recognize those individuals or groups who have excelled in creating and maintaining a safe and healthy workplace. Employees are encouraged to submit nominations for this award.

Nominees must have shown initiative demonstrated by satisfying one or more of the following criteria:

  1. For implementing an effective safety program in their unit.
  2. For being a strong advocate for safety in the UK community.
  3. For bringing about significant safety improvements or hazard reductions.
  4. For maintaining a good safety program over a period of years.
  5. For special efforts given to a specific aspect of safety in the workplace.
  6. For recommending or implementing a process that resulted in significant waste reduction.

NOMINEE INFORMATION
Name: Department:
Title: Building:
Describe why this individual or group is deserving of this award:
NOMINATOR INFORMATION
Name: Department:
Phone Number: E-mail Address:

Environmental Health & Safety