2018 Environmental, Health, and Safety Excellence Awards Program - Leadership Excellence Nomination

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2018 Environmental, Health, and Safety Excellence Awards Program

Leadership Excellence Nomination

Leadership Excellence Award Criteria:

The Environmental, Health, and Safety Leadership Excellence Award is intended to recognize and honor an individual in the top leadership position of a member company or facility (CEO or facility manager) that has demonstrated excellence through his/her leadership. The candidate being nominated should demonstrate organizational leadership skills and a strong commitment to manage environmental, health and safety programs as a core value of the organization.

Examples of award criteria that may be considered when nominating a leadership candidate include the following:

Establishes challenging goals and objectives for environmental, health and safety activities and communicates expectations throughout the organization. Drives the results through his/her modeled actions that lead to reduce risk, smaller environmental foot print, and prevent accidents.
Commits his/her time and company resources toward resolving environmental, health and safety concerns.
Communicates a clear vision for improved environmental, health, and safety results; participates in establishing the planning; and inspires others to align through personal example.
Demonstrates unwavering trust and integrity during decisions involving environmental, health and safety. Others feel empowered to make critical decisions to avoid risk without “checking in”.
Listens carefully to concerns involving environmental, health and safety with compassion and demonstrates a fair minded approach to resolution.

Name of Leadership Nominee and Nominee Job Title

Nominee *
PCA Member Company Name

Company *
Facility or Plant Name and Facility Location Address
Please provide the Facility/Plant Name and full physical address (Street Address, City, State/Province, Postal Code and Country)
Facility *
Total Number of Employees at Facility/Plant

Number *
Name and Contact Phone Number of Person submitting nomination form

Contact *		Phone *
Description of Nominee
Please provide a brief description of the Nominee’s position in the organization. Include a description of responsibilities and a brief summary of safety and health results achieved under his/her leadership.
Description *
Excellence in the workplace
Please describe specific examples of how the Nominee demonstrates excellence considering the examples of the criteria listed at the top of the Nomination Form. The examples may reflect work day activities and examples of decision quality that demonstrate a strong commitment to environmental, health and safety.
Examples *
Goal Setting Process, communication and participation
Please describe the organization’s goal setting process. Include specific examples of environmental, health and safety goals. Describe how the goals and objectives are communicated throughout the organization. Describe the Nominee’s participation in the process. Describe how year-end environmental, health and safety results are considered during performance reviews.
Process *
Leadership results and impact
Please describe the results the organization achieved under the Nominee’s leadership. Include any data the facility used to measure success. All metrics used to measure improvement in environmental, health, and safety is acceptable.
Results *
Supervisor Contacts
Please provide the names and contact information for two of the Nominee’s direct reports. By providing the names you are giving the PCA permission to contact them regarding the Nominee.
Name 1 *		Phone 1 *
Name 2 *		Phone 2 *

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