2019 Conservation Awards Nomination Form
Please provide information in the fields for the Nominee Information section and either the Nominator Information section or the Member Groups Nominator Information section
NOMINATION PROCEDURE
1. Nominations must be submitted on an official form, and can be submitted either electronically or by mail. Please refer to the mailing address and email address below.
2. Non-Ontario Nature members or groups are eligible for the awards, but they must be nominated by an Ontario Nature member group or two current Ontario Nature members. Nominees who are Ontario Nature members must also be nominated by two people (can be non-members) or one member group.
3. A person or group may be nominated for more than one award; however, each nomination must be submitted on a separate form.
4. Nominators must provide any supporting materials with their submission.
5. Ontario Nature must receive nominations by March 25, 2019.
6. Awards are given at the discretion of the Awards Committee.

Mailing Address:
Ontario Nature
Attn: Awards Committee Chair
214 King Street West, Suite 612
Toronto, ON M5H 3S6

Email Address:
Anna Dipple: annad@ontarionature.org

NOMINEE INFORMATION
1. Name of Nominee *
Your answer
2. Name of Award *
Required
3. Nominee's telephone (incl. area code) *
Your answer
4. Nominee's email address *
Your answer
5. Address (street, city/town, province, postal code) *
Your answer
6. Capacity in which the work was accomplished or performed. *
7. Time period in which the work was accomplish or performed (From when to when) *
Your answer
8. Indicate location/geographic area affected by the work done. *
Your answer
9. Provide a detailed summary of the nominee’s accomplishments. Include some details about the degree of difficulty associated with the task accomplished, the significance and benefits of the task, and a description of the attitude and leadership qualities of the nominee (please direct supporting documents to include with the nomination to annad@ontarionature.org) *
Your answer
NOMINATOR INFORMATION (Member groups please see next section)
Nominations require information endorsed by two nominators
Name (Nominator #1)
Your answer
Address
Your answer
Telephone (incl. area code)
Your answer
Email Address
Your answer
Name (Nominator #2)
Your answer
Address
Your answer
Telephone (incl. area code)
Your answer
Email Address
Your answer
NOMINATOR INFORMATION (Member group)
Name of member group
Your answer
Name and title of nominator
Your answer
Address
Your answer
Telephone (incl. area code)
Your answer
Email Address
Your answer
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