National Award for Road Safety 2025 Nominations You may use this offline (PDF form) to download and submit instead of completing the form below. Details of the applicantTitle*Surname*Given Names*Postal Address* Postal City*Post Code*Position / TitleOrganisation / Business Name*Organisation/Business Address* Organisation / Business CityOrganisation/Business Post CodeHome PhoneBusiness PhoneMobile Phone*Email* Details of the nomineeTitle*Surname*Given Names*Postal Address* Postal City*Post Code*Organisation / Business Name*Organisation/Business Address* Organisation / Business CityOrganisation/Business Post CodeHome PhoneBusiness PhoneMobile Phone*Email ASSESSMENT CRITERIA Your application can be about large or small projects, initiatives or products, but most notably you will need to demonstrate how the work you are doing is improving road safety and its direct impacts either locally, regionally or nationally in New Zealand. Your application must address each of the following criteria and provide evidence that substantiates its claims. The criteria used to assess and judge the submissions are common practice for Awards of such caliber. For each nomination received, the Committee will focus on the following: PART A Safety Concern identified PART B Solutions Developed PART C Project Evaluation and Outcomes PART A – SAFETY CONCERN WHAT WAS THE SAFETY CONCERN? 1. WHAT WAS THE ROAD SAFETY ISSUE AND OR CHALLENGE THIS PROJECT, PRODUCT OR SERVICE ADDRESSES? 2. PLEASE OUTLINE HOW YOU WERE ABLE TO DETERMINE THESE ISSUES OR CHALLENGES EXISTED?What factors determined the need for the project ? Part A Safety PART B – PROJECT, PRODUCT OR SERVICE 1. PLEASE OUTLINE THE DEVELOPMENT AND DELIVERY OF THE PROJECT, PRODUCT OR SERVICE?What was the innovative project, product or service developed to address the Safety Concern? Part B 1 2. WHAT OPTIONS DID YOU CONSIDER?Include solution development, how did you make your choice of option?Part B 2 3. WHO BENEFITS FROM THIS PROJECT? HOW AND WHY? How does this align with the Safe System and Vision Zero goals?Part B 3 PART C – EVALUATION AND OUTCOME 1. HOW WERE THE PROJECTS, PRODUCT OR SERVICES’ACHIEVEMENTS ASSESSED AND/OR MEASURED? Please outline how you have been able to demonstrate a reduction in deaths and serious injuries as a direct result of the project, product or service. 2. PLEASE OUTLINE HOW THE OBJECTIVES (BOTH IN TERMS OF PROJECT CHANGES AND ROAD SAFETY IMPROVEMENTS) HAVE BEEN MET. HOW DOES THIS PROJECT CONTRIBUTE TO THE ONGOING IMPROVEMENT OF ROAD SAFETY AND CASUALTY REDUCTION?Part C 1 Upload supporting document(s) Drop files here or Accepted file types: jpg, png, pdf, docx. attach any supporting files to your nomination JPG, PNG, PDF or DOCX formats
