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2021 Safety Professional of the Year Entry Form

As part of the Chairman and Awards Luncheon on Tuesday, September 14, OTA will recognize the 2021 Safety Professional of the Year. This award honors industry professionals who demonstrate excellence and passion within the safety profession.

All OTA members in good standing are able to nominate their employee or peer. Nominations are due July 30.

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Company Information

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Professional Qualifications

List names of every company by whom you were employed in trucking or allied industry, and the dates. Include job title, job description, and achievements (Use additional paper if necessary).

List any degrees or years of attendance at an educational institution above high school level.

List your participation in informal or in-service training, such as Fleet Supervisor Training Programs, hazardous materials training programs, etc. Include dates and any certification.

List your extra-curricular activities such as making safety lectures to other companies, schools, service organizations; writing newspaper/magazine articles; state and local safety meetings or programs, etc.

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Safety Record

Description of fleet or carriers under your direct supervision or direction. Include your authority, your policy, safety methods used of your creation, and safety improvement record.  Include current CSA records.

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Safety Activity Outside the Fleet

List years of active participation in safety organizations such as the Ohio Trucking Safety Council, Ohio Truck Driving Championships, All Ohio Safety Congress, National Safety Council, etc. Include offices held, committee work, etc.:

Personal Recognition: List any awards or recognitions you have received.  If applicable, the year certified by the National Committee for Motor Fleet Supervisor Training as Director of Safety, Motor Fleet Supervisor and Driver Trainer.

Include any other pertinent information about yourself you feel the committee could use in its selection.

In consideration of your nominee, the company and nominee and agrees to the following:

  • All of the statements contained in the application submitted are true to the best of the company’s knowledge.  The company to the best of its ability has investigated these statements and a company representative has personally reviewed with the nominee the facts contained herein.
  • It is understood and agreed to by the company that the nominee will attend the awards luncheon, September 14 at the Renaissance Columbus Westerville hotel, 409 Altair Parkway, Westerville, OH 43082.
  • Nominees agree to being photographed and videotaped during the awards celebration for event promotion.
  • Adhere to the Ohio Trucking Association’s Antitrust guidelines.

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