The Kenneth G. Wentink College of Fellows Application

Deadline for submission is January 31.

14%

NOMINATOR
Name
First Last
Primary Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Chapter
Membership Grade
Membership Number

CANDIDATE
Name
First Last
Primary Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Chapter
Membership Grade
Membership Number
Designations list (e.g. CPD, P.E., LEED, etc.)
If P.E. list states

EDUCATION
Highest Degree Received or Highest Level of Education: Degree Conferred or Field: Name of College/University/Institution: Date Received:

CATEGORIES
Check at least three (3) of the categories in which the candidate meets the criteria listed. Click here for a complete description.
- 1) Plumbing Engineering and Design
- 2) Plumbing Industry product or Service Application
- 3) Research and Development
- 4) Education
- 5) Leadership in the Industry
- 6) Leadership in the Plumbing Engineering and Design Profession
- 7) Plumbing Codes and Standards
- 8) Political Statemanship

PROFESSIONAL EXPERIENCE
List of principal positions held and dates, please briefly describe primary responsibilities for each position.
1) Professional Experience
Company Position Dates: From/To
Job Description/Responsibilities:
2) Professional Experience
Company Position Dates: From/To
Job Description/Responsibilities:
3) Professional Experience
Company Position Dates: From/To
Job Description/Responsibilities:

PROFESSIONAL RECOGNITION
List honors, awards, prizes or other notable recognition received from any relevant engineering or professional organization.
Organization Honor/Award/Prize/Recognition Description Date
Organization Honor/Award/Prize/Recognition Description Date
Organization Honor/Award/Prize/Recognition Description Date
Organization Honor/Award/Prize/Recognition Description Date
Contributions of Record
List of 5-10 signifiant publications and other contributions.
Principal ASPE Activities, Other Noteworthy Engineering Related Organizations Activities and Pertinent Public Services
Boards, Committees, etc.

REFERENCES
A minimum of three (3) references is required. All must be members of ASPE. Nominator is to select references who can attest that the candidate meets the criteria for the categories selected. Nominator is responsible for furnishing criteria outlined in categories selected. Reference from a member of the College of Fellows may be given special consideration by the program committee. Reference letters should be limited to 3 pages.
1) Reference Name
First Last
Primary Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Chapter
Membership Grade
Membership Number
2) Reference Name
First Last
Primary Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Chapter
Membership Grade
Membership Number
3) Reference Name
First Last
Primary Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Chapter
Membership Grade
Membership Number
Reference Letters
Upload pdf files of all References letters and any other necessary documents here.

NOMINATOR