Occupant Protection Awards

Highway Safety Occupant Protection Awards

Award Nomination

Agency Name

Agency Mailing Address

Chief/Sheriff/Post Commander Name

Chief/Sheriff/Post Commander Email Address

Agency County

Division Level

Total Number of Sworn Officers

Name of Nominee

Nominee Title/Rank

Number of Citations by NOMINEE from July 1, 2025 to June 30, 2026 (Occupant Protection - seatbelt and child passenger safety)

Number of Citations by ENTIRE AGENCY from July 1, 2025 to June 30, 2026 (Occupant Protection - seatbelt and child passenger safety)

Name of Individual Submitting Nomination

Submitter Phone Number

Submitter Email Address

Chief/Sheriff/Post Commander Will Attend:

NoYes

Nominee Will Attend:

NoYes