TEXAS SOCIETY OF PROFESSIONAL ENGINEERS

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2016 DALLAS YOUNG ENGINEER OF THE YEAR AWARD
Presented By The
DALLAS CHAPTER - TEXAS SOCIETY OF PROFESSIONAL ENGINEERS
This award recognizes young engineers who have made outstanding contributions to the engineering profession and
their communities during the early years of their careers.
NOMINATION FORM
Name of Nominee: __________________________________________________Date of Birth___________________
Company Name: _________________________________________________________________________________
Company Address: _______________________________________________________________________________
Company Phone No. : _______________________ FAX No. ____________________ E-Mail: __________________
Home Address: _______________________________________________________Phone No.:__________________
P.E. License Number and State: ______________________________________or, E.I.T. (State) ________________
Nominator: ____________________________ Phone No. (w)______________________E-mail:_________________
Eligibility - Minimum Requirements:
1. Age - 34 or younger as of January 1, 2016.
2. Licensed PE or E.I.T.; graduate of an ABET accredited engineering school
3. NSPE/TSPE member in good standing.
The TSPE Awards Committee makes the selection of the recipient based on the following Evaluation Criteria:
A.
Educational and Collegiate Achievements
12%
Include undergraduate and advanced degrees (give date, major, and institution for each), honorary societies (give society and office
held), scholastic awards, organizations (give name of organization and office held), and other activities
B.
Society of Professional Engineers Activities
15%
(National, State and Chapter levels of TSPE): List offices held, committee assignments, and awards at each level
C.
Technical Society Activities
12%
(ASCE, ASME, IEEE, AIChE, SPE, etc.) List offices held and committee assignments
D.
Civic and Humanitarian Activities
12%
List offices held and committee assignments
E.
Continuing Competence
12%
List graduate studies (give course and date), short courses and seminars, and papers published (give article, journal and date)
F.
Engineering Achievements
25%
Include current position (title, company, or institution), responsibilities (number of subordinates, annual budget), accountability
(position, function, nature of challenge), patents applied for, and awards
G.
Professional Experience
12%
Include dates of employment, employer/location, description of duties
Total
100%
Nomination Format and Submission Procedure:
Nominations must be made using this form. The form should be typed, and all supporting biographical information
should be provided and coded by the section number and title it supports, as outlined in the form. The information
should appear on a separate page for each lettered section. The nomination form should be submitted electronically.
Upon selection, the Award Recipient must submit a digital headshot (head and shoulders) with a minimum
resolution of 300 dpi. The Award Recipient should plan to participate in a photo shoot funded by TSPE for the
headshot.
Deadline:
Nominations are due at the email address below by Friday, December 4th, 2015.
Jack M. Young, PE, CFM, - TSPE EOY/YEOY 2016 Awards Chair
[email protected]
Page 1
PERSONAL DATA:
Candidate Name: ___________________
Date of Application: __________________
Birth Date:
Month: _________
Day: ____________ Year: ____________
NSPE Affiliation:
Chapter: ___________________________ State: ____________
NSPE Member Number: ___________________________________________________
Candidate’s Home Address: Street: _________________________________________
City: ________________________ State: ____________
Zip Code: ____________________
Candidate’s Daytime Phone: Area Code: _______ Number: _____--__________
Licensure:
Classification: _____________________ State: ____ License Number: ____________
Classification: _____________________ State: ____ License Number: ____________
Classification: _____________________ State: ____ License Number: ____________
Page 2
A. Education and Collegiate Achievements:
Include undergraduate and advanced degrees (give date, major, institution, and GPA for
each), honorary societies (give society and office held), scholastic awards, organization (give
name of organization and office held), and other activities.
Degrees:
Date: ____ Major: _________ Institution: _____________________ GPA: ____
Date: ____ Major: _________ Institution: _____________________ GPA: ____
Date: ____ Major: _________ Institution: _____________________ GPA: ____
Honorary Societies:
Society: ___________________________________ Office Held: ______________
Society: ___________________________________ Office Held: ______________
Society: ___________________________________ Office Held: ______________
Scholastic Awards:
Award: ______________________________________________________________
Award: ______________________________________________________________
Award: ______________________________________________________________
Organizations:
Name of Organization: ________________________ Office Held: _____________
Name of Organization: ________________________ Office Held: _____________
Name of Organization: ________________________ Office Held: _____________
Other Activities: ______________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Page 3
B. Professional Society Activities (national, state and chapter levels):
List offices held, committee assignments, and awards at each level.
National Office Held: __________________________________________________
National Office Held: __________________________________________________
National Office Held: __________________________________________________
State Office Held: _____________________________________________________
State Office Held: _____________________________________________________
State Office Held: _____________________________________________________
Chapter Office Held: ___________________________________________________
Chapter Office Held: ___________________________________________________
Chapter Office Held: ___________________________________________________
National Committee Assignment: _________________________________________
National Committee Assignment: _________________________________________
National Committee Assignment: _________________________________________
State Committee Assignment: ____________________________________________
State Committee Assignment: ____________________________________________
State Committee Assignment: ____________________________________________
Chapter Committee Assignment: _________________________________________
Chapter Committee Assignment: _________________________________________
Chapter Committee Assignment: _________________________________________
National Award: ______________________________________________________
State Award: _________________________________________________________
Chapter Award: _______________________________________________________
Page 4
C. Technical Society Activities:
List offices held and committee assignments.
Society: _____________________________________________________________
Office Held: _________________________________________________________
Office Held: _________________________________________________________
Office Held: _________________________________________________________
Committee Assignment: ________________________________________________
Committee Assignment: ________________________________________________
Committee Assignment: ________________________________________________
Society: _____________________________________________________________
Office Held: _________________________________________________________
Office Held: _________________________________________________________
Office Held: _________________________________________________________
Committee Assignment: ________________________________________________
Committee Assignment: ________________________________________________
Committee Assignment: ________________________________________________
Society: _____________________________________________________________
Office Held: _________________________________________________________
Office Held: _________________________________________________________
Office Held: _________________________________________________________
Committee Assignment: ________________________________________________
Committee Assignment: ________________________________________________
Committee Assignment: ________________________________________________
Page 5
D. Civic and Humanitarian Activities:
List office held and committee assignments.
Activity: _____________________________________________________________
Office Held: _________________________________________________________
Office Held: _________________________________________________________
Office Held: _________________________________________________________
Committee Assignment: ________________________________________________
Committee Assignment: ________________________________________________
Committee Assignment: ________________________________________________
Activity: _____________________________________________________________
Office Held: _________________________________________________________
Office Held: _________________________________________________________
Office Held: _________________________________________________________
Committee Assignment: ________________________________________________
Committee Assignment: ________________________________________________
Committee Assignment: ________________________________________________
Activity: _____________________________________________________________
Office Held: _________________________________________________________
Office Held: _________________________________________________________
Office Held: _________________________________________________________
Committee Assignment: ________________________________________________
Committee Assignment: ________________________________________________
Committee Assignment: ________________________________________________
Page 6
E. Continuing Competence:
List graduate studies (give course and date), short courses and seminars, and papers
published (give article, journal, and date).
Graduate Studies:
Institution: ___________________________________________________________
Course: ____________________________________________ Date: ___________
Institution: ___________________________________________________________
Course: ____________________________________________ Date: ___________
Institution: ___________________________________________________________
Course: ____________________________________________ Date: ___________
Institution: ___________________________________________________________
Course: ____________________________________________ Date: ___________
Short Courses and Seminars:
Course or Seminar: ___________________________________ Date: ___________
Course or Seminar: ___________________________________ Date: ___________
Course or Seminar: ___________________________________ Date: ___________
Course or Seminar: ___________________________________ Date: ___________
Papers Published:
Article: _____________________________________________________________
Journal: _____________________________________________ Date: __________
Article: _____________________________________________________________
Journal: _____________________________________________ Date: __________
Article: _____________________________________________________________
Journal: _____________________________________________ Date: __________
Page 7
F. Engineering Achievements:
Include current position (title, company or institution), responsibilities (number of
subordinates, annual budget), accountability (position, function, nature of challenge), patents
applied for and awards.
Current Position:
Title: ____________________________ Company: _________________________
Responsibilities: ______________________________________________________
_____________________________________________________________________
Accountability: _______________________________________________________
_____________________________________________________________________
Engineering Achievement: ______________________________________________
_____________________________________________________________________
Engineering Achievement: ______________________________________________
____________________________________________________________________
Engineering Achievement: ______________________________________________
____________________________________________________________________
Engineering Achievement: ______________________________________________
____________________________________________________________________
Patents Applied For: ___________________________________________________
Patents Applied For: ___________________________________________________
Patents Applied For: ___________________________________________________
Award: ______________________________________________________________
Award: ______________________________________________________________
Award: ______________________________________________________________
Page 8
G. Professional Experience:
Include dates of employment, employer/location, description of duties.
Employer: ___________________________________________________________
Location: ____________________________________________________________
Employed From Date: _________________ Employed To Date: _______________
Description of Duties: __________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Employer: ___________________________________________________________
Location: ____________________________________________________________
Employed From Date: _________________ Employed To Date: _______________
Description of Duties: __________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Employer: ___________________________________________________________
Location: ____________________________________________________________
Employed From Date: _________________ Employed To Date: _______________
Description of Duties: __________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Page 9
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