Member Leader Excellence Award

Use this award
for recognition of
Member Leaders
Recognize member individuals or teams for their outstanding commitment to ASQ and their communities / /

SECTION

/ Name
/ Number

Ordering

MEMBER

/ Name
/ Number
SHIPPING ADDRESS / Address
City
/ State/Prov.
/ Zip/Postal Code

Item number

/ Quantity / Cost per item /
Total
R104 N / $59pluss/h (above)
PAYMENT / MC/Visa AMEX / Number / Exp. Date
Purchase order / Number
Check
AWARD WINNER / Name/Team
/ Member Number
Member Status
AWARD WINNER / Name/Team
/ Member Number
Member Status
Limit of two awards per Member Unit each fiscal year.
Awards will be shipped 30 days after order is received. / Date Needed
SUBMIT TO:
Along with MLEA application form / Mail / E-mail / Fax
ASQ
Community Development
600 N. Plankinton Ave.
Milwaukee, WI53201 / / 414-765-8670
All orders received by February 28th will be included in the Honors and Awards Brochure at WCQI.
/ Member Leader Excellence Award
Section Nomination Form

Each section may award two (2) Member Leader Excellence Awards annually. Recipients of the MLEA may be individuals or teams. An award issued to a team is one award, even if multiple recipients will receive the plaque. Complete one form for each individual or team being awarded.

  1. Nominee Information

Individual name: / Team name:
If this MLEA is for a team, list names of team members:

II.MLEA Criteria.

  1. Membership. Candidate must currently be, or had been, a Regular Member of the Society and member unit presenting award during frame being recognized. Regular Members are:

Member / Senior / Fellow / Honorary / Designated Representative
of Sustaining Member
  1. Award criteria. Candidates should be rated on a scale of zero to five for each of the following criteria, with five being exceptional and long term contribution, zero being no contribution in that category. A candidate must meet a minimum score of 12 to qualify for this award.

Score / Criteria
Participation in educational activities at the local level. This includes courses taught at colleges and universities and to industry, courses taught for the member unit, papers presented at local conferences, section meetings, etc.
Participation in educational activities at the regional, national, or international level. This includes HQ-sponsored courses taught, papers presented at regional, national, or international conferences, etc.
Promotion of quality activities at local level. This includes participation in section, council, alliance or division activities as an elected officer, committee chair or participation in state quality award programs, etc.
Promotion of quality activities at the regional, national, or international level. This includes participation in an elected or appointed ASQ office at the regional, national, or international level, or participation on national quality awards programs, etc.

III.Section Information:

Section Name / Section Number

Submit this form, along with the MLEA order form to: ASQ Community Development, P.O. Box 3005, Milwaukee, WI 53201-3005; fax: 414-765-8670; email: