J. Stannard Baker Award for Traffic Safety

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J. Stannard Baker Award for Traffic Safety NSA Traffic Safety Award Nominations Requested Sponsored by: National Sheriffs Association 1450 Duke Street, Suite 204 Alexandria, VA 2234-3490 In Cooperation with: U.S. Department of Transportation National Highway Traffic Safety Administration The Traffic Institute of Northwestern University

Award Information The National Sheriffs Association is seeking nominations for the J. Stannard Baker Award. This award recognizes a sheriff or deputy sheriff who has made outstanding contributions to traffic safety. PURPOSE: SPONSORSHIP: AWARDS PANEL: CATEGORIES: CRITERIA: To establish a prestigious national award to recognize and employee(s) who has made significant contributions or accomplishments directly related to highway safety. The United States Department of Transportation - National Highway Traffic Safety Administration (NHTSA), and the Traffic Institute of Northwestern University, and the National Sheriffs Association. The annual award will be managed by the National Sheriffs Association. The selection panel will be comprised of members of the National Sheriffs Association - Traffic Safety Committee. An award will be given to an employee from any city/county Office of the Sheriff or any civilian within the nominating agencies jurisdiction. A. Development of Unique Law Enforcement/Community Traffic Safety Programs. This is to recognize an employee (officer, deputy sheriff) from an Office of the Sheriff who have shown unusual initiative and imagination in developing and promulgating traffic safety programs. A Heroic or Meritorious service act involving a traffic safety function is acceptable within the category. B. Special Award to Governmental or Private Individuals The award panel may grant a special award to any individual judged who has made an outstanding contribution to highway safety. QUALIFICATIONS: Candidates for the National Sheriffs Association - J. Stannard Baker Award for Highway Safety must be a full-time paid officer, deputy sheriff from a city/county Office of the Sheriff. The employer or civilian being nominated must have contributed to the highway safety program in their governmental agency. Long years of service are a consideration but not the determining factor. Equally, short services is to be considered. However, the quality of the service or program is the essential factor. To receive this ward, the individual must first be nominated by a law enforcement agency, traffic safety group or official, and second, must be a full-time paid employee of a city/county Office of the Sheriff. An individual from either the public or private sector, who has also made a significant contribution to highway safety would also be eligible for this award. This special award is designed to recognize the individual efforts of government employees, such as traffic engineers, educators, judges, prosecutors, moto vehicle examiners, etc., who have also made outstanding contributions to ghway safety programs and issues.

APPLICATIONS: RULES: To nominate an individaul, complete the following form and submit with supporting documentation, appropriate references, letter of support and photo-copies of news articles. Nominations to the J. Stannard Baker Award for Highway Safety must be submitted to the following address. (Two copies needed.) National Sheriffs Association Attn: J. Stannard Baker Award c/o Traffic Safety Committee 1450 Duke Street, Suite 104 Alexandria, VA 22314-3490 SPECIAL NOTATION: Send a copy of your entire document to: National Highway Traffic Safety Services Police Services U.S. Department of Transportation Room 5119-N NTS/41 400 Seventh Street, SW Washington D.C. 20590 Applications shall be submitted by the nominating law enforcement agency or other traffic safety group of official. Nominations for this award must be received at the National Sheriffs Association Headquarters by May 1, 2011. The Traffic Safety Committee - Award Panel may or may not grant award, at its discretion. ANNOUNCEMENT OF WINNER(S): The winner will be invited to the NSA Annual Conference and Exhibition (the month of June), where the award will be presented. Travel expenses will be provided for the winner only. The winner of this yearly award shall be notified of their selection prior to the 15th day of March of each year.

Award Application NAME OF NOMINATING AGENCY OR PERSON: ADDRESS: CITY: STATE: ZIP: TELEPHONE: FAX: NAME OF NOMINEE: TITLE OF NOMINEE: NOMINEE S EMPLOYER: ADDRESS OF NOMINEE: CITY: STATE: ZIP: TELEPHONE: EMAIL: LAW ENFORCEMENT AGENCY: q Sheriff q Other FULL-TIME EMPLYEE: q Yes q No CONTRIBUTION IN RELATION TO EMPLOYEE: q Yes q No CANDIDATES CONTRIBUTIONS ARE FOR ONLY q Yes q No DATE CANDIDATES CONTRIBUTIONS ARE CUMULATIVE INCLUDING LAST YEAR DATE q Yes q No

Award Application: Description of Meritorious Activities

Award Application: Description of Major Accomplishments

Award Application: Signature Page Please Print Name and Title Date Submitted Signature