Nomination Form

Applicants must self-select a nomination category and may apply for two categories, using separate applications.

Nominations open on March 6th, 2012 and nomination applications must be submitted via the Bellmon website and received by May 7, 2012.

The Quality of Life for All Award will be given to the applicant that demonstrates improved quality of life for community members by empowering, improving living conditions, encouraging healthy places to live, work, and play, or all of the above (or similar), while balancing responsible economic growth and environmental stewardship.

The Responsible Economic Growth Award will be given to the applicant that demonstrates healthy economic growth through local job creation, entrepreneurial green jobs, support for local businesses, or all of the above (or similar), while balancing quality of life for all and environmental stewardship.

The Environmental Stewardship Award will be given to the applicant that demonstrates protection of natural resources and ecological communities by reducing waste, restoring ecosystem health, protecting habitat, or all of the above (or similar), while balancing quality of life for all, and responsible economic growth.

The Henry Bellmon Award, the most prestigious award, will be given to the applicant that exemplifies sustainability leadership by a balanced approach in all three key areas.

Please fill out the form below to nominate yourself or someone else for the Bellmon Sustainability Awards.

The form below will not save your work. If an error occurs, your information will be lost. We recommend that you save your responses in another application before entering your nomination. Thank you.

Application for:*
- the Quality of Life for All Award
- the Responsible Economic Growth Award
- the Environmental Stewardship Award
- the Henry Bellmon Award
My nomination is a:
Name of Nominee (company, nonprofit, group, agency or individual)*
Number of Employees (if applicable)
Number of individuals the nominee impacts
(Examples: 5, 500, unknown)
Name of Project (if available)
What year was the program/project initiated?
Please enter a value less than or equal to 2012.
Contact for Project*
Contact Work Number
Contact Cell Number
Contact Email Address*
Name of Individual Completing the Application*
Applicant Work Number
Applicant Cell Number
Applicant Email Address*
How did you hear about the Henry Bellmon Sustainability Awards?*
If "other", please describe:*
Provide a brief summary of your company/project/individual nominated for an award as it specifically applies to sustainability:*
(200 words or less)
Provide a general description of the organization, company, community or individual:*
(200 words or less)
Name and short description of the applicant’s program(s) or project(s) for consideration:*
Include specific objectives/goals. Not to exceed 1000 words.
Describe the program or project impact:*
Address three aspects of how the program(s) or project(s) achieve(s/d) success:
(A) Achieving success in developing innovative solutions in a targeted area(s) of sustainability
(B) Achieving a high level of success in adaptation/implementation of sustainable practices
(C) Achieving success in integrating all three aspects of sustainability: quality of life, responsible economic growth, and environmental stewardship.
(D) How does the nominee demonstrate leadership in sustainability for Oklahoma?
Not to exceed 2000 words

Nomination Form

The Time

Gala Sponsors

Brannin Family Foundation

Randy Sullivan Family Trust

Partners

Judges

Dave Lawson

Dean VanTrease

Susan Savage

Brett Fidler

Dr. William Focht

Ann McFerron

Jim Cameron

Tom Klenda

Felicia Collins Correia