Wellness Champion Nomination 2019
The Fundy Wellness Network would like to recognize the important contribution that many people make as Wellness Champions in the community by honoring them during New Brunswick’s Wellness Week: October 1-7, 2019.

Wellness Champion Recognition Criteria
1. Nominee(s) can be any age
2. Wellness initiative has taken place during the past year (October 2018 to September 2019)
3. Promotes all or any one of the 7 dimensions of Wellness (Physical, Mental, Emotional, Environmental, Occupational, Spiritual, Social)
4. From the community of: Quispamsis, Rothesay, Saint John or Grand Bay/Westfield
5. First time nominee only (past wellness champions are welcome to join the celebration ceremony)
6. Nominations will be reviewed by the FWN Board to ensure nominees fit the criteria. Nominees with the sole intention to promote a specific product and/or service will not be accepted.

Here are just a few examples of our FWN Wellness Champions:
-A community member advocating for smoking cessation
-A father-daughter duo organizing a bike drive for youth
-A workplace offering many health and wellness opportunities for their employees
-Community members starting a walking group to explore trails in the KV area

Nomination Instructions
1. Nomination forms are due on or before Tuesday, September 10th, 2019
2. The FWN Board assumes no responsibility for lost, delayed, or misdirected applications.
Please complete your Wellness Champion Nomination Form online at
www.fundywellness.ca: or scan and email to fundywellnessnetwork@gmail.com

Select Wellness Champion Category *
Name of Wellness Champion *
Your answer
Address
Your answer
Telephone Number *
Your answer
Email Address *
Your answer
Describe your wellness champion *
Why are they deserving of this award. Describe their involvement in wellness initiatives and activities.
Your answer
Verification of submission. *
Required
Name of nominator *
Your answer
Email of nominator *
Your answer
Phone number of nominator *
Your answer
Date *
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