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NOMINATION FORM

KANATA NORTH COMMUNITY RECOGNITION AWARDS 2014

Nomination Categories
The nomination categories include the following: Citizen of the Year An individual who has exemplified community spirit and throughout the years has demonstrated what it means to be a true community builder. This individual has continually gone out of their way to be actively involved and participate within our community. Senior Citizen of the Year An individual or couple age 65 or older who has made a significant and longstanding contribution to our community. This individual or couple has been continually committed to giving back to the community over the years. They have demonstrated selflessness and the utmost interest in bettering the community. Youth of the Year An individual age 19 or younger who has contributed to the community through leadership, volunteer services, peer support, emergency situation response, or is someone who has overcome a personal challenge. This individual has taken on the role of being an example for other youth in the community, and will continue to grow to become a leader of tomorrow. This individual resides and/or attends school in Kanata North. Organization of the Year A non-profit organization, community group, service, club, or business that has demonstrated social responsibility, and continues to enhance the well-being of the community through volunteer or charitable efforts. Nominees in this category may be of any organizational size, are located in and/or benefit Kanata North. GENERAL REQUIREMENT: All nominees for all categories must either reside in and/or have done volunteer or charitable efforts to benefit Kanata North.

How to Submit the Nomination Form


Submit this Nomination Form to Councillor Wilkinson at The Kanata North Ward Office, Mlacak Centre, 2500 Campeau Drive, Kanata, 2nd floor, Mail to Councillor Wilkinson, City Hall, 110 Laurier Avenue West, Ottawa, Ontario, K1P 1J1, The Richcraft Recreation Complex-Kanata, 4101 Innovation Drive, or By email to Kanata.North@ottawa.ca.

Submissions must be received on or before April 4th, 2014.

Thank you for your nomination. We appreciate you recognizing those who have made a significant contribution to Kanata North.

NOMINATION FORM
KANATA NORTH COMMUNITY RECOGNITION AWARDS 2014

Nominator/Nominee Information
Nominator (your information)

Name: Address: Telephone Number: Email Address:


Nominee

Name: Address: Telephone Number: Email Address:


Select the specific category for which you are nominating this individual or organization: Citizen of the Year Senior Citizen of the Year Youth of the Year Organization of the Year.

Provide a detailed written submission indicating why you are nominating this individual or organization:

If you require additional pages, please attach them to the Nomination Form.