Nomination Form

Project DetailsProject name:

Project value (if applicable):

Completion date:

2016

Please complete this form and return it to the NECA WA office. Once your nomination form has been processed, you will receive a copy of the NECA Excellence Awards nomination guide and judging criteria.

The submission closing date for completed projects is Friday 27 May 2016.

Please fill out one form per category entered. Tick the category you are submitting

Category Entered

8 Voice - Data

9 Commercial - Small Project

10 Commercial - Medium Project

11 Commercial - Large Project

12 Work Health and Safety

12

1 Domestic Residence

2 Small Contracting Business

3 Energy Efficiency and Environment

NECA WA ARE NOT PARTICIPATING IN CATEGORY 4

5 Industrial - Small Project

6 Industrial - Medium Project

7 Industrial - Large Project

Company DetailsCompany name:

Contact name:

Address:

Business telephone: ( )

Email address:

Postcode:

Please tick the box if you would like NECA WA to provide free assistance with the

preparation of your submission.

Western Australia ChapterUnit 18/199 Balcatta RoadBALCATTA WA 6021 PO BOX 782 BALCATTA WA 6914T +61 8 6241 6100F +61 8 9240 4866E events@necawa.asn.au

2015 NECA EXCELLENCE AWARDS

(WA State only category, not judged

at National Excellence Awards) The same project may be

entered into more than one

category.

Please return this completed

form to the NECA WA office.

Mobile:

2016 NECA EXCELLENCE AWARDS