Community Champion Award Nomination Form
The Community Champion Award was created to honour an individual who makes significant contributions to our community, through their time, actions, talents, advocacy, and dedication to help us provide basic needs, dignity and comfort to people living in poverty and help to stimulate action to address the root causes of homelessness. The honouree selected should serve as a role model for compassion and be striving to make the world a better place. They should have a passion for helping others in their community and believe that every person deserves respect and deserves to live with dignity.

Eligibility:
Any community member may be nominated with the exception of any paid staff member or board of director of Shelter House.

Criteria:
Persons being nominated for this award will have consistently demonstrated qualities of compassion and has shown enormous support towards Shelter House Thunder Bay.

The winner of this award will be notified on Monday, October 21st, 2019 to make arrangements to attend the SOS Fundraising Dinner on Saturday, November 2nd, 2019. The winner of the award will also receive one free ticket to the event to accept the award. If the individual is unable to attend, a representative may be sent in their place.

Nominations will close Tuesday, October 15th, 2019.

If you have any questions please do not hesitate to contact Kimberley by phone at 474-4357, or by email at Kimberley.Kennedy@shelterhouse.on.ca.
Nominee's Information
When you are nominating, please make sure to include their correct contact information so we can connect with them in the event that they are the chosen as the winner of this award. Name and telephone number are required.
Name (first and last) *
Your answer
Phone Number *
Your answer
Email Address
Your answer
Tell us why you want to nominate this individual. *
Your answer
Nominator's Information
We require your contact information to send confirmation that we've received your nomination. Your information will not be sent to our panel of judges.
Your Name (First and Last) *
Your answer
Your Phone Number *
Your answer
Your Email Address
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.