Besadny Nomination Form

Nominee: Submitted By: 
* Name:  * Name:
(if appropriate)
(if appropriate)
Address: Address:
* City: * City:
* State/Province: * State/Province:
Postal Code: Postal Code:
Phone: * Phone:
* Email address:

1. In brief, how has your nominee fostered Great Lakes partnerships. Please limit to 50 words or less.

2. Please describe how the nominee has displayed an exemplary commitment to building or strengthening partnerships. Please provide examples of partnerships in which the nominee has been involved that benefit the Great Lakes ecosystem. Please limit to 300 words or less.

3. Please describe how such partnerships significantly improved the Great Lakes ecosystem or management. Please limit to 150 words or less.

4. Please provide brief biographical information:

OR attach the nominees' CV (please limit to one-page)

5. Please enter the number displayed here: