Welcome to the 2025 USLA Ben Carlson Lifeguard of the Year Award Nomination Form!

Please complete all sections of this form to submit your nominee. Ensure that your submission is thorough and includes detailed examples that showcase the nominee's excellence in their role as a lifeguard. Supporting documents can be uploaded at the end of the form.

Nomination Deadline: August 10, 2025

Nominator Information

Nominator's First Name *		Nominator's Last Name *
Nominator's Email Address *		Nominator's Phone Area Code *
Nominator's Phone *		Nominator's Relationship to Nominee *e.g., Supervisor, Colleague, Other
Nominee Information

Nominee's First Name *		Nominee's Last Name *
Nominee's Email Address *		Nominee's Area Code *
Nominee's Phone Number *		Nominee's Employing Agency *
Is the Nominee currently employed as a lifeguard? *Nominees must be actively employed as a lifeguard.	Yes No	Nominee's Position *Must be non-management
Years of Experience as a Lifeguard *Minimum of two years in open water lifeguarding required.		Is the Nominee a Current USLA Member? *Nominees must have an active USLA membership to be eligible.	Yes No
Categories of Excellence
For each category, provide detailed narratives and examples. Nominees must excel in at least three areas.
Leadership / Mentorship *Describe the nominee's leadership roles, mentorship activities, and any significant incidents where their leadership was evident.
Integrity & Honesty *Provide examples of how the nominee demonstrates sound decision-making, professional pride, and the promotion of public trust.
Teamwork & Reliability *Explain how the nominee positively affects team dynamics, their attendance, punctuality, and collaboration with team members.
Effective Communication *Detail how the nominee maintains high service standards and adheres to agency policies, including examples of effective public interactions.
Commitment to Professional Development *Outline the nominee's efforts in professional growth, training, maintaining fitness, and mastering aquatic environments, including understanding marine conditions and advanced rescue techniques.
Strong Work Ethic *Highlight instances where the nominee has exceeded job requirements with exceptional dedication and reliability.
Upload Supporting DocumentsUpload any additional documents that support the nomination, such as letters of recommendation, commendations, or evidence of achievements.
Additional CommentsAny additional comments or information you wish to include.
Senior Leadership Endorsement
Endorsement must be provided by senior leadership.
Endorser First Name *		Endorser Last Name *
Endorser's Position *		Endorser Email Address Name *
Has the highest ranking officer in your organization been notified? *	Yes No	Highest Ranking Officer First Name (If different than endorser)
Highest Ranking Officer Last Name (if different than endorser)		Highest Ranking Officer Email AddressPlease provide this information if the endorser is not the highest ranking officer. The highest ranking officer will be contacted for nomination approval.

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Welcome to the 2025 USLA Ben Carlson Lifeguard of the Year Award Nomination Form!