Email and Phone Number. Mailing Address ... evaluation plans) â no more than 10 pages of text, not including graphics,
2013 National Roadway Safety Awards Nomination Application Jointly sponsored by the U.S. Department of Transportation Federal Highway Administration and the Roadway Safety Foundation Project Name Submitted by (name of agency or organization) Agency/Organization Point of Contact Email and Phone Number Mailing Address
Parent Organization(s)/Project Owner(s) (if different from submitting agency) Program Categories (check all that apply) Infrastructure Improvements Operational Improvements Program Planning, Development, and Evaluation Type of Funds Used (check as applicable) State and/or Local Federal-Aid Highway Federal Highway Safety Program (Section 402) Private Sector Other (please specify)
Has this project been initiated within the last five years?
Yes
No
Entry Documentation Required Completed application form Project description – no more than 15 pages The description should include the following: • Summary of the overall problem(s) and safety problem(s) addressed – no more than two pages. • Comment on project’s applicability to award criteria and program category (provide a brief statement explaining how your project meets the criteria of effectiveness, innovation, and efficient use of resources) – no more than three pages. • Supporting documentation (e.g., data-supported results/reports, safety statistics and outcomes, evaluations and/or evaluation plans) – no more than 10 pages of text, not including graphics, photos, or videos. Photos – include at least one, but no more than three photos, not to exceed 5” x 7”; if sending electronically, photo files should not exceed 3.0 MB per image. The 2013 National Roadway Safety Awards Noteworthy Practices Guide will include an image for each award recipient. Press releases and media coverage, if applicable See reverse for submission deadline and mailing/shipping details.
Multiple entries must be submitted separately. Electronic submissions are encouraged. Applications and corresponding required documentation may be submitted electronically to
[email protected] or via U.S. Mail or express shipping company as follows:
2013 National Roadway Safety Awards c/o Ms. Heather Rigdon 800 Corporate Drive Suite 401 Stafford, VA 22554
All nominations must be received by March 31, 2013 to be considered. The program is available to U.S. nominees only, including U.S. territories and funded operations such as District of Columbia, Puerto Rico, Guam, and the Mariana Islands.
FHWA-SA-12-032
