2003 SHIP SAFETY ACHIEVEMENT AWARD
Please fill out Online form or Print PDF and submit to:
Safety Award Committee
Chamber of Shipping of America
1730 M Street, NW, Suite 407
Washington, DC 20036

Name and Address (for award notification):
Name:
Company:
Address:
Telephone No:
Fax No:
Email Address:
Name of Vessel:
Owner:
Type of Vessel (dry cargo, tanker, etc.)
Size of Vessel:
Date and Time of Incident:
Location of Incident:
Attach a narrative of the incident, providing as many details of the circumstances as possible. (Additional information, such as pictures, newspaper articles, press releases, etc., is encouraged). In preparing your narrative, please consider the following: 1. Were weather conditions hazardous or unusual? 2. Did the crew react quickly and professionally to an emergency situation? 3. Did the operation result in the saving of lives or property. 4. Describe damage, if any, sustained by vessel(s). 5. Describe demonstrations of above the ordinary safety training, seamanship, or unusual personnel qualifications or capabilities. 6. Describe acts of individual or collective heroism or humanitarianism. 7. Was onboard equipment used in an unusual or extraordinary manner? Please submit entry to: Safety Award Committee Chamber of Shipping of America 1730 M Street, NW, Suite 407 Washington, DC 20036 Submitted by: Date: