ACEEE | Exemplary Energy Efficiency Programs Nomination Form

ACEEE 3^nd National Review and Recognition of Exemplary Energy Efficiency Programs

Nominations due by midnight, October 5, 2012

Please provide the following information. Items marked with a red asterisk are required fields:

Program Name: *

State(s) in which program operates: *

Customer sector(s) targeted:

Technology/end use(s) targeted, e.g., lighting, HVAC, process, etc.:

Program approach and services provided. Keywords only, please:

Brief Synopsis (25 words or less):

Administrating organizaton/ company. If multiple organizations are involved, please describe the program structure (roles and responsibilities of the different organizations) Note: Organizations may only nominate themselves for three programs each):

Source of funding:

e.g., customer rates, systems benefit charge or tarriff/ rate rider

Approximate annual budget:

For most recent year available. Please include year.

Useful web links. If the program has a website, or evaluations or annual reports are available online, please include the URLs here:

Description of the program (see note below):

(limit 2 pages) Please be sure to describe the services provided (what, how and by whom). Include brief background of the program--particularly when the program began, how it has developed, any key changes over time, and, if so, why such changes were made. You are welcome to attach supplemental materials--there's an upload tool at the end of this form.

Reasons for nomination (see note below):

(limit 1 page) Why is this program exemplary? Please consider the following factors in describing program performance and achievements: Direct Energy Savings and Other Benefits, Market Impacts, Cost Effectiveness, Customer Service and Satisfaction, Innovation, and Transferability, Number of Participants, "Depth" of Energy savings (Percent Energy Saved per Participant/Project

Person submitting nomination: *

Position: *

Organization: *

Phone: *

Email address: *

Mailing address:

Contact person for program (if different):

Phone:

Email address:

Additional documents (Click the "Browse..." button and find your ZIP file. The document will be uploaded when you complete the nomination form):

Supplementary information and/or documentation may be uploaded as zip files in a zip folder containing .doc, .pdf, .jpg, and .xls files. Zipped folder uploads may not exceed 2 MB in size.

CAPTCHA

This question is required to prevent automated spam submissions.

Exemplary Energy Efficiency Programs Nomination Form

ACEEE 3nd National Review and Recognition of Exemplary Energy Efficiency Programs

ACEEE 3^nd National Review and Recognition of Exemplary Energy Efficiency Programs