Administrative Information
Award coordinator POC:
Name:
Telephone:
Email:
Organization, Group, or Team
Name:
Mailing Address:
Address (continued):
City: State: Zip:
Primary Organization Point of Contact (POC)
Name:
Title:
Telephone:
E-mail:
Alternate Organization POC
Name:
Title:
Telephone:
E-mail:
Current Number of Employees:
Your organization, group, or team’s mission statement:
Brief description of your organizational structure:
Chain of command to whom your organization, group, or team reports:
Names and position titles of individual(s) contributing to organization, group, or team:
Award Narrative
(Two pages maximum, 12-point Times New Roman, 1” margins, based on criteria described herein)
Award Citation Abstract
(Maximum 300word summary that will be placed in the award program for the winning teams)
ATTACHMENT 1
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