Mathias - Lesczynski 2016 Award
Mathias - Lesczynski Water Quality Award 2016 Entry Form
Applicants will be considered for the award upon submitting a completed entry form no later than December 1, 2016. The application can be submitted in a number of ways:
- Complete and submit the form on this page, matching the numbered question to the number on the form
- Download the form as a Word document, then submit as an attachment on the form below or email to email@example.com
- Print the Word document, then fill it in by hand and mail to: LWQIA, PO Box 1716, Fond du Lac, WI 54936-1716
Supporting materials (maps, photos, etc.) may be scanned and attached to form, emailed or mailed.
L.W.Q.I.A. may request award recipients and selected applicants to participate in advancing the Mathias / Lesczynski Award program by sharing their accomplishments during various L.W.Q.I.A. promotional efforts.
- 1) Applicant(s) Name
- 2) Farm/Business Name (if different)
- 3) Mailing Address
- 4) Location of Operations (if different)
- 5) Phone
- 6) Email
- 7) Type of Farm Operation (dairy, cash crop, etc.)
- 8) Describe changes you have made in conditions and/or operations for the 2016 growing season to help protect surface waters from runoff of sediment, nutrients and chemicals.
- 9) What were the expected or observed results of these changes to conditions/operations?
- 10) What local, state or federal agencies or other organizations or consultants assisted you in designing and/or implementing these changes?
- 11) List any community service, agricultural, or conservation organizations in which you are active and indicate any leadership roles.
- 12) Type in the name of the person filling out the form
- 13) Date