Innovation Awards Application Form

Instructions for Filing Application

For the Safety Innovation Award, your company must have played a proactive role in developing a new safety initiative.

We will consider new programs, methods, or applications of technology as examples of what sets the safety innovator apart from others. Describe innovative and creative solutions that effectively solved industry safety challenges and problems.

You must include at least one contact name and number for any company/trade that benefited from the innovation.

Deadline for Filing Application: Must be submitted before midnight February 16, 2026.

Questions: Direct any questions to (219) 226-0300.

Reserve your tickets and sponsorship today at https://nwibrt.org/caf-nwibrt-safety-awards-banquet/ or call 219-226-0300.

The awards will be presented at the Annual Safety Awards Banquet at the Avalon Manor Banquet Center on May 7, 2026.

Criteria for Application Evaluation can be found at https://nwibrt.org/award-criteria/

Nominator's Name:*

First NameLast Name

Nominator's Company:*

Nominator's Email for Return Notification:*

example@example.com

Nominator's Phone Number:*

You must include at least one contact name and number for any company/trade that benefited from the innovation:*

	Company	Name	Title	Phone	Email
Reference one:
Reference two:
Reference three:

Innovation Essay: Describe in detail (in 1 attached page) your innovative contributions to safety that would qualify you for this award.*

Upload pictures of contribution:

Companies being considered do not have to meet any of the criteria for the other listed awards.

Nominator's Signature:*

Innovation Award Application