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2013 WEC Gold Medal Award Nomination Form

This form must be submitted by August 10, 2012. Candidates will be notified of their eligibility no later than August 17, 2012, and invited at that time to submit the full Gold Medal Application. Full applications are due October 12, 2012.

All fields are required.

Nominee Information

Information on the Nominee Company.

Nominee Company ■

Name of Nominee Company

Address ■

Address of Nominee Company

Parent or Subsidiary ■

Is Nominee a Parent Company or Subsidiary?

Parent
Subsidiary

Number of Employees ■

Sales ■

Sales in US Dollars ($)

Annual Report ■

URL of the company's annual report.

The Environmental and Sustainable Development Policies ■

Briefly describe the environmental and sustainable development policies and practices that illustrate the Nominee's qualifications for the WEC Gold Medal.

Manufacturing or Processing Locations (if applicable)

List countries where the Nominee Company has manufacturing or processing facilities, if applicable.

Information about the Nominator

Please enter information about you.

Name of Nominator ■

Your Full Name.

Title ■

Your Title

Affiliation ■

Your Affiliation with the nominated company.

Address ■

Your mailing address

Phone Number ■

Your phone number; please include country and area codes.

Fax Number

Your fax number; please include country and area codes.

Your E-Mail Address ■

Clicking the submit button will save your nomination to our database. Thank you for your nomination.

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