Salute to Women Award - Nomination Form
Nominator/Nominating Organization Information
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Name of Nominator/Nominating Organization:
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Contact Name:
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Address:
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Phone (a.m.):
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Phone (p.m.):
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Nominee's City of Residence:
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Name of Nominee:
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Address:
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Phone (a.m.):
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Phone (p.m.):
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AWARD CATEGORY:
Required! Nominator must designate the award for which each nominee is a candidate. Please note that the Selection Committee reserves the right to place nominees in a category other than for which they are nominated. The more information provided about the candidate, the easier it is to fairly consider the nomination. It places the nominee at a disadvantage if complete information is not submitted with the nomination form.
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The Susan Lowell Butler Lifetime Achievement Award
The Marguerite Payez Leadership Award
Women's Health and Safety Advocate Award
Youth Community Services Award
Leadership in Business and Career Development Award
Marian Van Landingham Legislation and Public Policy Award
Making a Difference Award
Vola Lawson Award
Rising Star Award
Donna Bergheim Cultural Affairs Award
NOMINEE'S CONTRIBUTION TO THE COMMUNITY:
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Describe the the nominee's contribution to the community, be specific and provide all of the following information
How has the nominee made the community a better place for women and girls?
How has the nominee become a role model or an inspiration for other women in their professional and personal lives?
Include specific examples of the nominee's efforts to develop, establish or enhance a particular program or project.
DETAILS MATTER - The list of contributions must provide sufficient information to give the selection panel a good sense of the nominee's accomplishments.
SUPPLEMENTAL MATERIALS:
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Submit supplemental materials, including at least two letters of recommendation along with articles or other information about your nominee. We strongly suggest a minimum of two pages of supplemental material, with a limit of five pages. File size must be less than 4MB. The following file types are allowed: .doc, .docx, .txt, .pdf, .jpg, .jpeg, .gif, xls, .xlsx
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Name:
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Acknowledgement:
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By submitting this form, I hereby declare and affirm that all the details stated herein are true and accurate to the best of my knowledge.