California State University Channel Islands Foundation
Business & Technology Partnership (B&TP)
5th Annual B&TP Leadership Dinner
2009 Technologist of the Year Award
Nomination Form
The CSUCI Business & Technology Partnership is seeking nominations for the Technologist of
the Year Award. Business owners and companies are encouraged to nominate individuals who
they feel are deserving of recognition for their significant contributions to technology and the
community in Ventura, Santa Barbara and northern Los Angeles Counties. The honoree must
work in any of the three aforementioned counties and their community service must have
contributed to the betterment of the region.
ELIGIBILITY REQUIREMENTS:
In order to qualify for the Technologist of the Year Award, nominees must be:
1. A technologist in Ventura, Santa Barbara or northern Los Angeles Counties.
2. Has contributed to or supported education.
EVALUATION:
Nominees who meet the initial eligibility criteria will then be further evaluated. Some aspects to
be considered include:
1. Outstanding contributions to new and/or innovative products, processing technologies, or
productivity leading to enhancing business
2. Long-standing Community Involvement & Leadership
3. Promoting Quality Education
4. Excellent technology delivery leadership skills
Nominee's Name:________________________________________
Title:___________________________________________________
Company _______________________________________________
Address: ________________________________________________
City and Zip: ____________________________________________
Phone: _________________________________________________
Email: _________________________________________________
Fax: ___________________________________________________
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