Nominee Information |
Individual Name or Organization Name: |
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Profession or Business: |
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Mailing Address: |
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City: |
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State: |
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Zip: |
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Telephone Number: |
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Email Address: |
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Category for which the individual or organization
is nominated |
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Nominator Information |
Name: |
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Mailing Address: |
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City: |
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State: |
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Zip: |
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Telephone Number: |
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Email Address: |
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Nomination |
1. What has this person or organization contributed
to improving our environment or furthering the cause of natural
resource conservation? |
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2. In the case of an individual has the contribution
been primarily as a professional or private citizen? |
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3. Has the individual or organization had a history
of commitment to conservation? |
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3a. For how long? |
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4. Will this individual or organization continue
to further the cause of conservation in the future?
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4a. How? |
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Complete the following for CONSERVATIONIST OF THE
YEAR NOMINEE ONLY |
1. How has this individual or organization made a contribution
of such significance as to be known statewide or nationally? |
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2. How has this individual’s or organization's conservation
efforts become recognized as influencing positive changes in matters
affecting the environment? |
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3. How would this recognition serve to create a broader interest
in conservation and by example, encourage others to outstanding accomplishments
on behalf of our state's natural resources? |
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Support documentation may be sent via email to Dr.
Cathy Shropshire, mailed to Mississippi Wildlife Federation, 517 Cobblestone Court, Suite 2, Madison, MS 39110 or faxed to (601) 605-1794.
Please make sure you note the nominee and the category. |
Will you be sending support documentation? |
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