The National Roadway Safety Awards program is available to U.S. applicants only, and eligibility is restricted to public agencies that have implemented a relevant project for public roadway safety benefit. Other groups that have been involved in successful roadway safety efforts (e.g., private entities, academic institutions, nonprofits, etc.) may cosponsor a nomination, provided that a public agency is the lead applicant. Multiple entries from the same agency are permitted, but an agency can only win one Award per program cycle. All nominations must be submitted through the online portal by 11:59 PM EDT June 16, 2023 to be considered. In order to complete this form, you will need to complete the nomination form below and upload the required supporting documents. PROJECT INFORMATION Project Name * Agency Name * Name of Program Point of Contact * Name of contact * Title * Mobile Phone Email * Office Phone * Website * Parent Agency(s)/Project Owner(s) (if different from submitting agency) Secondary Program Point of Contact * Secondary Program Point of Contact * Title * Title * Office Phone * Office Phone * Email * Email * PROJECT DETAILS PROJECT TIME FRAME Start Date * Month * MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Year * Year202320222021202020192018201720162015201420132012201120102009 End Date (if applicable) Month MonthJanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember Year Year202320222021202020192018201720162015201420132012201120102009 Award Category * Infrastructure & Operational Improvements Program Planning, Development and Evaluation Type of Funds Used (Check all that apply) * State and/or Local NHTSA Safety Program (Section 402) Federal-Aid Highway Private Sector Other (please specify) Type of funds Other (please specify) Has your agency previously submitted this project for a Roadway Safety Award? * Yes No Does the project or program include some type of engineering, infrastructure or operations solution?* In order to submit the application this option * Please note, to be considered for an award, the project or program must include at least one of these components/elements. Yes Has this project/program been internally evaluated for performance? * If yes, please indicate the analysis period. Yes No Analysis Period * PROJECT DESCRIPTION Executive summary * Please provide an executive summary which identifies the safety concern, the solution and the results (2,000 character limit). Project Description * Please provide a 280 character ('Tweet-length') summary of the project or program that could be used to promote winning entries on social media. PROJECT QUOTE FROM SENIOR OFFICIAL * Quote * Please provide below a quote from a member of the agency's senior management showing support for the project or program for the purpose of public dissemination in promotional material. Please include the name, title and agency of quoted individual. UPLOADS Project description * The description should include the following: - Summary of the overall problem(s) and safety problem(s) addressed. - Comment on project’s applicability to award criteria and program category (provide a brief statement explaining how your project meets the criteria of effectiveness, innovation, and efficient use of resources) Project description * File must be uploaded before submitting the form.Files must be less than 5 MB.Allowed file types: pdf doc docx ppt pptx. Supporting documentation * Supporting documentation is limited to 10 pages, and any content in excess of this limit will not be reviewed. Supporting documentation can include data-supported results/reports, safety statistics and outcomes, evaluations and/or evaluation plans. Supporting documentation * Files must be less than 5 MB.Allowed file types: txt pdf doc docx ppt pptx. Photo * Include at least one, but no more than five high-resolution photo files, each of which should not exceed 3.0 MB per image. Please submit a caption for each photo submitted and provide names and contact information for any individuals that appear in any submitted photographs. The 2021 National Roadway Safety Awards Noteworthy Practices Guide will include at least one image of each winning project. Photo * Files must be less than 5 MB.Allowed file types: gif jpg jpeg png. For ADA purposes, please provide a description of this photo * A description for this photo * Contact information for individual(s) appearing in photo. Photo Files must be less than 5 MB.Allowed file types: gif jpg jpeg png. For ADA purposes, please provide a description of this photo * A description for this photo Contact information for individual(s) appearing in photo. Photo Files must be less than 5 MB.Allowed file types: gif jpg jpeg png. For ADA purposes, please provide a description of this photo * A description for this photo Contact information for individual(s) appearing in photo. Photo Files must be less than 5 MB.Allowed file types: gif jpg jpeg png. For ADA purposes, please provide a description of this photo * A description for this photo Contact information for individual(s) appearing in photo. Photo Files must be less than 5 MB.Allowed file types: gif jpg jpeg png. For ADA purposes, please provide a description of this photo * A description for this photo Contact information for individual(s) appearing in photo. Add another photo Press releases and media coverage (if applicable) Files must be less than 5 MB.Allowed file types: txt pdf doc docx ppt pptx. By submitting this nomination, the applicant provides FHWA with a royalty-free, nonexclusive and irrevocable right to reproduce, publish, or otherwise use the application materials, including all photos for Federal purposes, and to authorize others to do so including the Roadway Safety Foundation for use in National Roadway Safety Awards promotional materials. AGREE * Agree Math question * 2 + 11 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.
