Nominate A Woman Who Inspires You!
Thursday, March 8th, 2018 is International Women's Day, a day where we celebrate women's achievements, contributions, and recognize the vital role women play in making our country a better place.

Please take a few moments to fill out the form below to nominate a girl or woman who inspires you, through their hard work, dedication and contributions to the empowerment of women.

Applications are due by Thursday, March 15th, 2018.

If you have any questions or concerns, please do not hesitate to call my office 905-848-8595 or email me at omar.alghabra@parl.gc.ca.

Application
Your Full Name *
Your answer
Phone Number *
Your answer
Address *
Your answer
City *
Your answer
Postal Code *
Your answer
Email Address *
Your answer
Nominee's Information
Name of the Nominee *
Your answer
Nominee's Address *
Your answer
Nominee's Postal Code *
Your answer
Nominee's Email Address *
Your answer
Please outline some of the accomplishments of the person you are nominating *
Your answer
What is your relationship to them?
Your answer
How do they inspire you? *
Your answer
Why do you think they will be an ideal recipient of this recognition? *
Your answer
Submit
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