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The 2023 Peter K. O'Rourke Special Achievement Award Nomination Form

This award recognizes notable achievements in the field of highway safety by individuals, coalitions, organizations, nonprofits, businesses, government agencies, universities and/or the media. Up to three awards will be presented in 2023.

Submissions may include an impactful highway safety program, plan or legislation addressing, but not limited to, the following: occupant protection; impaired or distracted driving; speeding or aggressive driving; traffic enforcement; traffic records; emergency medical services; and bicycle, micromobility, motorcycle and/or pedestrian safety.

Past Special Achievement Award Winners

IMPORTANT: Please read before beginning your nomination!

Winners are expected to submit relevant images, photos and/or b-roll that GHSA will use to produce a short video. GHSA will work with the winners to record a brief interview for inclusion in the videos. In lieu of a formal awards presentation, the videos will be shown at the GHSA Annual Meeting in New York City, August 12-16. Winners may be invited to speak about their award-winning initiative during an Annual Meeting workshop.

Partial Form Completion — If you want to begin a nomination and complete it later, use the Save & Return button below.
Form Submission — Your nomination is NOT complete until you press the Submit button. Once you submit your nomination, a confirmation screen will appear, and you will receive a confirmation email with a copy of your nomination.
Deadline — The deadline for nominations is March 6. Winners will be selected and notified in April.
Travel Expenses — GHSA has limited funding for travel reimbursement. Requests will be handled on a case-by-case basis.

Questions? Contact Adrian Nicholas at anicholas@ghsa.org or 202-580-7934.

Save & Return

Save your progress and complete this form later. (optional)

Nominated Person or Organization *

Contact Information for the Person/Organization Being Nominated

First Name *

Last Name *

Title *

Organization *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Questions

Provide a brief description of the nominee's accomplishments. *

Why was the program, plan or legislation implemented? What problem did it address? Did it target a priority area in a state's Strategic Highway Safety Plan or an issue of national concern? *

What are the outstanding elements and accomplishments of the program, plan or legislation? Were new or creative approaches to the problem utilized? *

Were there any limitations or special challenges encountered by the nominee? How were they overcome? *

Did the nominee receive any public or private funding? If yes, how much and from whom? *

Describe any new partnerships involved in the program, plan or legislation's implementation. *

How has the nominee impacted highway safety in the state or nationally? What have been the benefits of the nominee's efforts? Please be as specific as possible and include any hard data as evidence to support your nomination. *

Contact Information for the Person Completing this Nomination