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IPM Achievement Award - Nomination Form

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You can nominate a candidate by filling out and submitting this form. You can make your nomination brief as we will get details from the nominated groups. If you have problems using this form contact Melissa Plemons at (916) 445-8411, fax at (916) 324-9006 or e-mail at Melissa.Plemons@cdpr.ca.gov

The deadline for nominations for the 2016 awards is June 30.


Candidate Organization or Group:


1.
Contact Information   (Please complete all fields)

(a).    Contact person for the Organization:
 Name:   
 Address:
 Telephone:
 FAX:
 E-mail:
     
(b).   Name of person making nomination. We may want to contact you for more information. Please provide telephone number and email.
 Name:
 Telephone:
 E-mail:
   
2.   Why does this organization or group deserve an IPM Achievement Award?
 



For content questions, contact:
IPM Achievement Award Program
Melissa Plemons
Pest Management & Licensing Branch
P.O. Box 4015
Sacramento, CA 95812-4015
Phone: (916) 445-8411
Fax: (916) 324-9006
E-mail: Melissa Plemons@cdpr.ca.gov