New Mexico Leopold Conservation Award Nomination Form

Name:*

First Name Last Name
Name of Farm, Ranch, or Business:*
Primary County(s) of Operation:*
Website:
Address:*

Mailing Address

Address Line 2

City State / Province

Postal / Zip Code
Email:*
example@example.com
Phone Number:*
Name of Nominator, if different from nominee:
If you are selected for the Leopold Conservation Award, how would you like your name to appear on the award: (Examples: John Smith, John Smith and Family, Smith Family Farms)*

Please address the five criteria below, and limit each response to 1,000 words.
1. Conservation Ethic – Describe how the nominee has voluntarily exceeded the minimumobligations of regulation to enhance and conserve natural resources. *
2. Resilience – Describe the business and conservation methods used by the nominee to make the operation productive into the future. *
3. Leadership and Communication – Describe significant efforts the nominee has made to share his/her conservation ethics and techniques with others inside and outside of agriculture. Describe community service, positions held, leadership roles and media outreach. *
4. Innovation and Adaptability – Describe how the nominee has taken risks by utilizing or experimenting with new techniques to adapt to change (consumers, markets, weather, regulations, etc.). *
5. Ecological Community – Describe how the nominee’s agricultural operation works with natural systems (soil, water, plants and wildlife, etc.). Describe how this benefits others. *
Describe any other relevant accomplishments and/or challenges.

Please provide this additional information:

Your responses to the following do not impact the selection of the Leopold Conservation Award recipient. This information is intended to help the judges learn more about your practices.
The number of acres under management (there is no minimum or maximum acreage required).*
Provide a one line description of your farm/ranch/forest (examples: dairy farm with cash crops; cow/calf beef operation; integrated forestry with focus of pulp wood production).*
Which local, state, federal agencies or partner organizations are involved with the nominee’s conservation practices?*
Which, if any, federal conservation programs do you utilize (e.g. EQIP, CSP, CRP)?
Which, if any, farm advisors do you work with (e.g. crop consultant, Extension agent)?

Attach three letters of recommendation.

At least one should be from a natural resources conservation organization or agency.
Letter of Recommendation 1

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Letter of Recommendation 2

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Letter of Recommendation 3

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By signing below, you agree to the following statements.

If you are nominating someone else for this award, please sign below, agreeing to submit a signed document from the nominee to the selection committee.
1. I agree to be a nominee for the Leopold Conservation Award.
2. I manage and/or own the property described in this application.
3. The agricultural operation described in this application is in compliance with all applicableregulations, and provides a positive example of environmental stewardship.
4. I understand I may be asked to be available for communications/media opportunities topromote the message of voluntary private lands conservation.
5. I understand a video will be produced featuring my agricultural operation, which will requiremy participation.
Signature*

Clear
Should be Empty:

Please address the five criteria below, and limit each response to 1,000 words.

Please provide this additional information:

Attach three letters of recommendation.

By signing below, you agree to the following statements.