Safe Driver Award Application

Safe Driver of the Year Award Application

Nominations for the Joseph M. Kaplan Safe Driver of the Year Award are open from January 1 to April 30 each year. View the award criteria»

Section A: Nominator Information (please print)

Date Submitted:

Membership Id # (of location):

Company Name:

Company Street Address (No PO Boxes):*

City*:

State/Province*:

Zip/Postal Code:*

Application Submitted by:

Title:

Phone:

Email (REQUIRED: Winners notified by email):*

Section B: nominee information (please print)

Driver name:

Area:

Total # of years driven without a preventable collision throughout career:*

Total # of miles driven without a preventable collision throughout career:*

# of safe driving years employed with current company:

# of safe driving years employed with previous company (if any):

Total # of preventable incidents during career:*

Dates of preventable collision (MM/DD/YYYY):

Type of vehicle(s) authorized to operate:

Please write a brief statement that you feel is relevant for the consideration of this nominee.

I agree to receive communications from NSC*

Our Mission

The National Safety Council is America’s leading nonprofit safety advocate. We focus on eliminating the leading causes of preventable injuries and deaths.

Contact Us Privacy & Terms

© 2026 National Safety Council