2015 FLC

STATE AND LOCAL ECONOMIC DEVELOPMENT AWARD

***** SUBMISSION DEADLINE: OCTOBER 31, 2014*****

2015FLC StateandLocal Economic DevelopmentAward

Nomination Form

The FLC State and Local Economic Development Award recognizes successful initiatives that involve partnership between state or local economic development groups and federal laboratories for economic benefit.

Award Criteria

Nominees of the 2015State and Local Economic Development Award will be judged on the following criteria:

  1. Nominees must include FLC laboratory employees, and can include employees of state and/or local economic development groups directly involved in the initiative.
  2. The nomination must provide a clear explanation of the partnership, the innovative approach to addressing a need, and demonstrable results.
  3. The nomination should include background on the context in which the initiative operates and why it was created including information about the geographic area the initiative serves.
  4. The nomination must describe the specific roles, goals, objectives, and contributions of each nominee.
  5. The nomination must describe any innovation or creativity demonstrated by the nominee(s), including mechanisms utilized.
  6. The nomination must describe what has been the impact to date, and how that impact is determined.

Submission Guidelines

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  • Nomination narrative should not exceed threepages.
  • Use Arial or Times font styles that are no smaller than 12 points.
  • The completed nomination form must adhere to the electronic page format created by the FLC. Do not alter headers, footers, margins, or use electronic page formats from previous versions of the nomination form.
  • Do not attach supporting documentation (e.g. brochures, newspaper articles, press releases).
  • Do not include links to websites, homepages, etc.
  • Section A and Section B of the nomination form must be sent electronically to the FLC Management Support Office at . The form must be submitted in either an MS Word or a standard PDF format. Please do not send forms that have been scanned.
  • Section C of the Submission Verification form must be signed by the individual submitting the nomination and it must be faxed to the FLC Management Support Office (attn: Michele Chambers) at 856-667-8009.

Submission Deadline

Both the Nomination form and Submission Verification form must be received by the FLC Management Support Office by 8:00 p.m. EDT (5:00 p.m. PDT) on Friday, October 31, 2014. No submissions will be accepted after this time.

Announcement of Results

The winner of the FLC 2015State and Local Government Award will be announced in January 2015. Laboratories submitting nominations will be notified prior to the official announcement.

Award Presentation

The winner will be honored at the 2015FLC National Meeting in Denver, Colorado.

1 2015FLC State & Local Economic DevelopmentAward

FOR FLC USE ONLY – DO NOT COMPLETE OR REMOVE
RECEIVED: SUBMISSION NUMBER:

2015FLC State & Local Economic DevelopmentAward

Section A – Contact Information

NOMINATOR INFORMATION

Name:

Title:

Organization:

Address:

City:State:Zip:

Phone:Fax:E-mail address:

NOMINEE #1 INFORMATION

Name:

Title:

Organization:

Address:

City:State:Zip:

Phone:Fax:E-mail address:

NOMINEE #2 INFORMATION (if you plan to submit more than two nominees for this award, provide the contact information on the following page)

Name:

Title:

Organization:

Address:

City:State:Zip:

Phone:Fax:E-mail address:

A-1 2015FLC State & Local Economic DevelopmentAward

NOMINEE #3 INFORMATION

Name:

Title:

Organization:

Address:

City:State:Zip:

Phone:Fax:E-mail address:

NOMINEE #4 INFORMATION

Name:

Title:

Organization:

Address:

City:State:Zip:

Phone:Fax:E-mail address:

NOMINEE #5 INFORMATION

Name:

Title:

Organization:

Address:

City:State:Zip:

Phone:Fax:E-mail address:

A-1 2015FLC State & Local Economic DevelopmentAward

2015FLC State & Local Economic Development Award

Section B – Nomination Narrative

B-1 2015FLC State & Local Economic Development Award

2015FLC State & Local Economic DevelopmentAward

Section C – Submission Verification

(This page will only be accepted via fax at 856-667-8009)

NOMINEES:

Only include names and organizations

NOMINATOR INFORMATION:

Name:

Title:

Laboratory:

Address:

Phone: Fax: E-mail:

C-1 2015FLC State & Local Economic DevelopmentAward