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SOCIETY OF PETROLEUM ENGINEERS, INC. Nomination for SPE Regional Service Award (The SPE Regional Service Award recognizes exceptional contributions to the Society at the regional level.) 1. Nominee: Job Title: Company Affiliation: Mailing Address:   2. Biographical sketch of nominee. Include education, job positions, and technical and professional contributions. (Attach separate sheet.) 3. SPE offices held and service to the Society through committee work. List section and Society offices held and service on section and Society committees, including regional and topical meeting committees. Also list participation in SPE programs; such as the Distinguished Lecturer Program or Short Course Programs. Complete in detail and explain special nature of contributions. (Attach separate sheet.) 4. Publications. Do not restrict to SPE publications. (Attach separate sheet.) 5. Service to country, state, community or public. (Attach separate sheet.) 6. Citation. Submit a concise (approximately 30 words) supporting statement as to why the nominee should be selected as a recipient of the award for use as the basis for the official citation should the nominee be selected. (Attach separate sheet.) 7. Nominator Address Phone E-mail 8. Date Please submit 7 copies of your nomination to: Mr. Khalid Aziz Stanford U. Green Earth Sciences Building #65 Stanford, CA 94305-2220 Telephone 650/723-9116 Facsimile 650/725-2099 E-Mail aziz@pangea.stanford.edu For office use only Date nomination received Years of eligibility