Caring Haldimand

Nominator Name*
First Last
Nominee Name*
First Last
Nomination Process:
- For a Nominee to be considered, the Nomination Form must be completed in full and submitted with supporting documents outlining the Nominee’s achievements. Please ensure you include all volunteer activities of the Nominee;
- Eligibility and Criteria: Any Individual, Not-for-Profit or Organization may submit more than one nomination. An Individual, Not-for-Profit or Organization may nominate themselves;
- Political and public advocacy work are not eligible and will not be considered; and,
- It is the responsibility of the Nominator to inform the proposed Nominee of the submission. By submitting an entry you automatically grant Haldimand County the right to use any materials in the entry for editorial, analytical, promotional or any other purpose without additional permission or compensation.
Caring Haldimand Award Criteria:
- An Individual, Not-for-Profit or Organization;
- The primary volunteer activity/event must have taken place in the past 18 months. A Recognition Night recipient from the previous year is not eligible to be nominated in the same category;
- Has initiated, organized or implemented an event or activity supporting health, social or community services; and,
- The event/activity directly or indirectly benefitted Haldimand County residents.
Nomination Must Include:
- The applicable Nomination Form with all sections and questions completed in full;
- Extra pages if more space is required; and,
- Other supporting materials (e.g. publications, photos, media stories, video, etc.).
PLEASE NOTE NOMINATIONS WILL BE JUDGED AS PRESENTED.
Nominee Information
Individual, Not-for-Profit or Organization*
Mailing Address*
Street Address City Postal Code
Email*
Phone*
Nominator Information
Individual, Not-for-Profit or Organization*
Mailing Address*
Street Address City Postal Code
Email*
Phone*
Nomination Form
Using the Award Criteria, please provide specific details when describing the Nominee.
Focus on successful volunteer efforts, contributions and accomplishments.
1. Identify the cause/focus of the Individual, Not-for-Profit or Organization and explain how their efforts are making a difference in Haldimand County.*
(Minimum 250 words; maximum 500 words)
2. Describe how the Individual, Not-for-Profit or Organization initiated or organized an event or activity within the past year with the goal of supporting health/social/community services.*
(Minimum 250 words; maximum 500 words)
3. Please include any additional information you feel is relevant.*
(Minimum 250 words; maximum 500 words)
IT IS THE RESPONSIBILITY OF THE NOMINATOR TO ENSURE THIS APPLICATION HAS BEEN COMPLETED IN FULL WITH ALL SUPPORTING DOCUMENTATION.
Consent*
I verify that the information provided on the form is factual.
Signature*
Date
MM slash DD slash YYYY
For assistance call 905-318-5932, ext. 6370 or email: cdp@haldimandcounty.on.ca.
Remember to Include:
- Extra pages if more space is required; and,
- Other supporting materials (e.g. publications, photographs, media stories, video, etc.).
Supplementary Information:
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Email
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Caring Haldimand

Nomination Process:

Caring Haldimand Award Criteria:

Nomination Must Include:

Nominee Information

Nominator Information

Nomination Form

Using the Award Criteria, please provide specific details when describing the Nominee.

Remember to Include:

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