NASTC Drivers of the Year Award Nomination Application

Company Name:*

Member Since:

Address:*

City:*

State:*

Zipcode:*

Phone:*

Person Making Nomination:*

Title:*

Email:*

Driver Name:*

Miles Driven in 2022:*

Total Years Driving:*

Years With Your Company:*

Accident Free Miles (total career miles / total miles since last accident if applicable):*

Time Without an Accident (in years/months):*

Driver License Number:*

License State:*

Date of Birth*

Explain briefly why this driver is your nominee for our Drivers of the Year Award: (2000 chars left)*