West Midlands Regional Awards Entry Form 2021
Please refer to the West Midlands ‘Call for Entries’ document
prior to completing this form.
A submission fee of £200 + VAT must be paid in full via credit
card or BACS at the time of submission. Deadline for entries is
12:00 noon on Friday, 19 March 2021.
Checklist
Please confirm what files will be sent with this Entry Form
(Please put an X in the appropriate field)
ITEM
1
Document title (edit in footer)
Registered charity number 210252
Charity registered in Scotland number SC038629
Project Entry Form (electronic copy – PDF format) with all
participating organisations details and signatures
Please note: Paper submissions (in whole or part) will not be
accepted.
Consent and signatures from all partners
Executive Summary
Awards Submission
Project Submission (electronic copy – PDF format)
Project value
Entry fee payment: £200+VAT – please specify how the fee is
paid
By Credit Card
By BACS
Images
(how many)
Logos
(how many)
Plans and Drawings
Please contact ICE West Midlands for payment details and send
completed forms via WeTransfer to [email protected].
Please refer to WM Regional Awards – Checklist to ensure all
required documents are submitted.
Project Details
Project name:
Location:
Date of (substantial) completion:
Contact Details – Submitting Organisation
Contact name:
Organisation:
Organisation’s Social Media accounts:
Twitter: LinkedIn:
Role in project:
Address:
Telephone:
Email:
Signature:
Date:
Contact Details – Partner(s) Please insert more tables if
necessary
Contact name:
Organisation:
Organisation’s Social Media accounts:
Twitter: LinkedIn:
Role in project:
Address:
Telephone:
Email:
Signature:
Date:
Contact name:
Organisation:
Organisation’s Social Media accounts:
Twitter: LinkedIn:
Role in project:
Address:
Telephone:
Email:
Signature:
Date:
Contact name:
Organisation:
Organisation’s Social Media accounts:
Twitter: LinkedIn:
Role in project:
Address:
Telephone:
Email:
Signature:
Date:
Contacts for communication
Please provide details of two contacts who would be able to
provide quotes about the project and would be your point of contact
for potential filming/ interviews.
Contact name:
Organisation:
Role in project:
Telephone:
Email:
Contact name:
Organisation:
Role in project:
Telephone:
Email:
Project Summary
Please provide a 150-word project summary for inclusion in
Awards marketing and promotion.
Award Submission
Award summary, not exceeding 500 words. Please refer to the West
Midlands ‘Call for Entries’ document, in particular the judging
criteria to ensure all criteria are covered in your submission.
People Award Nomination Form (No fee)
Personal details
Are you making the nomination on behalf of yourself
Yes / No
Your name
Your email address
Nominee’s name (leave blank if self-nominating)
Nominee’s email address (leave blank if self-nominating)
Nominee’s ICE membership number
Please attach a head shot of the nominated person
Is the nominee aware they are nominated for this award?
Y/N
(Delete as appropriate)
· Bob Dunn Award
· Young Achiever of the Year Award
· Technician of the Year Award
Please put your name and contact details in the ‘Submitting
Organisation’ box at the top of the entry form. For ICE STEM
Ambassador of the Year Award please refer to a separate form.
Nominee’s full name:
Nominee’s contact details (email and telephone number):
Nominee’s organisation and place of work:
Provide a citation as reason for nomination (maximum 500
words):
1
Institution of Civil Engineers is a Registered Charity in
England & Wales (no 210252) and Scotland (SC038629)
Document Title – Edit in footer
1
Document title (edit in footer)
Registered charity number 210252
Charity registered in Scotland number SC038629
2
Institution of Civil Engineers is a Registered Charity in
England & Wales (no 210252) and Scotland (SC038629)
ICE West Midlands Regional Awards 2021
– Entry Form
