Name:
Title:
Organization:
Address:
City:
State:
Zip:
Telephone:
Email:
1. Which Star Award is this individual being nominated for?
Enforcement Emergency Medical and Trauma Services Engineering Child Passenger Safety Judicial/Court System Education
2. Briefly describe how the nominee has displayed leadership in his/her field.
3. How has the nominee motivated and/or collaborated with others in efforts to move toward zero deaths on Minnesota's roads?
4. Please share an example that portrays the nominee's creativity in improving traffic safety in Minnesota.
5. Please note any connections the nominee has with the Minnesota TZD program.
6. Are there any other noteworthy accomplishments that do not specifically apply to the questions above that you would like the selection committee to consider? If yes, please briefly describe.
