International Driver Excellence Award (IDEA) 2018 Nomination Form

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As the leading organization overseeing the coordination of uniformity of commercial motor vehicle safety enforcement and regulatory compliance across Canada, the United States and Mexico, the Commercial Vehicle Safety Alliance (CVSA) recognizes the exceptional careers of professional commercial motor vehicle drivers and their commitment to public safety. CVSA officially acknowledges these individuals through the annual International Driver Excellence Award (IDEA). This annual award recognizes individuals who go above and beyond the performance of their duties as a commercial vehicle driver, distinguishing themselves conspicuously and beyond the call of duty through the achievement of safe operation and compliance carried out with evident distinction for an extended period of time. The nominated individual must be of personal character beyond reproach with no disqualifying past behavior, as indicated in the award criteria. Procedure IDEA is open to the entire industry. You do not have to be affiliated with CVSA to apply. The deadline for applications is Friday, Jan. 12, 2018. Complete applications must be received at CVSA headquarters by the deadline date. All materials must be mailed together in one envelope. No email submissions will be accepted. Partial packets will not be considered. No exceptions. All nominators will receive a letter confirming CVSA s receipt of their nominee. Nomination packets will not be returned to the sender after the 2018 award program has concluded. The IDEA Program Committee will review and authenticate IDEA nominations. CVSA is not required to select a winner if the nominees do not exemplify the qualities of the IDEA program. The final decision to recognize the nominee will be made by the CVSA Board of Directors. The award winner will be selected and announced in March 2018. Announcement of the IDEA winner will be shared through a press release, as well as on the CVSA website and in its print magazine, through social media and other forms of communication. The Award The award winner will be presented with his or her award at the 2018 CVSA Workshop in Portland, Oregon on Monday, April 9, 2018. The winner will receive a trophy and a monetary award. Airfare to Atlanta and hotel accommodations for the award winner and one guest will be covered. IDEA Nominee Criteria Checklist The driver must meet the below criteria to be considered. Check off all statements on the below checklist that are true of the nominee. If all of the boxes cannot be truthfully selected, the driver is not a candidate to receive this award. Driver has at least 25 cumulative years of crash-free driving in a commercial motor vehicle (CMV) with a clean driving record for the past three years. Driver has no felony convictions. Driver has no safety-related driving suspensions in the past three years. Driver has no driver violations in past three years, excluding form and manner violations. Supporting Documentation You must provide all of the below listed supporting documentation together with the nomination form for the nominee to be considered. If additional space is needed to sufficiently fill out the nomination form, feel free to include additional pages. Pre-Employment Screening (PSP) report (United States) or Driver Abstract (Canada) or Mexican equivalent Must include at least the five-year history and three-year inspection history. Motor vehicle record (MVR) Three-year history Statement of Truth from the Nominator By signing below, you are officially stating that the facts and information contained on this nomination form and within all of the supporting documentation are true and accurate. Signature Date NOTE: You are encouraged to remove the nominee s social security number from all documents containing that information. Page 1 of 5

International Driver Excellence Award (IDEA) Nominee Name: Title: Company: Company Address: Home Address: Phone Number: Email Address: Nominator (if different from the Nominee) Name: Title: Relationship to Nominee: Company: Company Address: Home Address: Phone Number: Email Address: Nominee s Driving Record Type(s) of Vehicle Driven: Type of Driver: n Local n Regional n OTR Approximate Number of Miles Driven: Total Number of Driving Years: Number of Years Operating at Current Company: Page 2 of 5

Nominee s Interests and Accomplishments Hobbies: Community Involvement (civic, industry-related, volunteering, etc.): Other Awards Received: Page 3 of 5

Statement of Consideration Please explain below why we should consider the nominee. Describe how the nominated driver has gone above and beyond the performance of his or her duties as a commercial vehicle driver, distinguishing themselves conspicuously and beyond the call of duty through the achievement of safe operation and compliance carried out with evident distinction for an extended period of time. Page 4 of 5

Submission Directions Mail the completed nomination form and accompanying material to: CVSA ATTN: IDEA Committee 6303 Ivy Lane, Suite 310 Greenbelt, Maryland 20770 The deadline for applications is Friday, Jan. 12, 2018. All nominators will receive a letter confirming CVSA s receipt of their nominee. Page 5 of 5