Clean50: Detailed Clean50 INDIVIDUAL Nominee Questionnaire
THANK YOU FOR YOUR INTEREST IN CANADA'S CLEAN50.

Detailed responses are now being accepted for the next Canada's Clean50 Award - The 2018 Clean50 - with results to be announced in September 2017 and appear in the Globe and Mail in November.

Nominations officially open on April 22nd, 2017, and close July 4th. However - if you can see this before April 22, you may enter your information at any time before the deadline. DEADLINE EXTENDED to JULY 12 th

The Clean50 Summit 7.0 takes place Thursday September 28th, on Toronto Island, at the Royal Canadian Yacht Club.

Clean16 Individual awards will be made from wood reclaimed from the actual maple tree that inspired our first unofficial anthem 150 years ago, known as the "Maple Leaf Forever Tree". Other awards will include pieces of the tree
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PLEASE ! Read the FAQ tab on the Clean50 website before you begin. It will help you avoid common mistakes.

SECONDLY: The data you enter here lives forever in our database and is hard to correct later. Spelling mistakes and typos in names, titles, company names - they are your responsibility. Every year someone objects to being Ms. Peter Smith or Mr. Patricia Jones. Or Petel Smuth. or Patecia Jonrs. This core data in the database is much harder to correct than anything else. So - PLEASE take special care in providing accurate names, titles, company names etc.. All need to be entered IN EXACTLY THE WAY you would want them to appear in the Globe and Mail, press releases, publications and on the Clean50 website. ANSWERING IN ALL CAPS - OR in all lower case - will also really mess us up - so please! - don't do that! Especially important for names, titles and company names etc.

DEADLINES SET: The deadline to have been nominated is JULY 1st.. Anyone nominated by then has until 10 AM July 4th EDT to complete this LONG form (or a week from the date they are notified of their nomination, whichever is the later date).

One key reminder from the FAQs

** Will the form expire?

Once you start, there is no time limit for completing the form (beyond the deadline date). Simply ensure you keep it open in your browser until complete. If you make an error you will be able to edit it, even after submission, by emailing us an update.

Do NOT press the BACK button / back arrow on your BROWSER or REFRESH your browser. You will lose all of your entries! Use only the "back button" on the form, at the bottom of each page on the form.
Pressing the Back ARROW in the navigation box on your web browser, or using your BACK arrow near or part of your numeric keypad ERASES ALL THAT YOU HAVE TYPED WITHOUT WARNING.

In some cases, if you have configured your backspace key to be the same as the Back Arrow, it will do the same. As this is actually a GOOGLE doc form filler, managed by Google, we have no control over this feature. If this happened to you we are so very sorry!

Instead, to go back, you should only use the BACK BUTTON at the BOTTOM of each PAGE, on the FORM. Repeat NOT YOUR BROWSER BACK BUTTON or ARROW, or the "back arrow" key.

If you need to make a correction or amend your response, please email us the changes - although Google theoretically allows you ONCE YOU HAVE SUBMITTED to edit the responses. - To be safe, complete your response BEFORE attempting to GO BACK. When you do so do not use the browser arrows - use the "back" button at the bottom of each section page.

WE HIGHLY RECOMMEND EDITING YOUR RESPONSE IN WORD BEFORE SUBMITTING - and then cutting and pasting into the form. That way if something goes wrong with the form, you will still have the information to cut and paste back into the document. A Word version of the questions can be obtained by sending us an email to clean50@deltamanagement.com

If you wish to ask questions please contact us via email: clean50@deltamanagement.com or via telephone: Gavin Pitchford; 416.925.2005 x 2300. We are VERY approachable! If you need help or clarification, please don't hesitate to call or send an email to gpitchford@deltamanagement.com.

Our Clean50 Champions!
Our profound thanks to our already committed Champions as we seek Clean50 version 7:

Delta Management Group
---- Based in Toronto, Delta Management is Canada's leading search firm for "green & clean professionals", including CSR, Sustainability, responsible investment and clean tech professionals, operating across Canada. Delta founded the Clean50 in 2011 and has remained the primary sponsor and steward of the awards ever since. Our partners all have impeccable sustainability pedigrees, and offer us great support in furthering this unique-in-the-world award and Summit.

HP Canada
---- Canada's greenest IT company, HP has been a leading sponsor of the Clean50 since 2012

Unilever
---- The world leading consumer packaged goods company has committed to being better than carbon neutral in their operations by 2030 and demonstrates leadership every day,

The Globe & Mail
--- Canada's National Newspaper, the Globe provides us with 2 whole pages in the Report on Business each year to recognize our honourees, now for the fourth year. The Globe also features significant amounts of Clean50 content the same week as the public announcement is made.

CN Rail
--- CN Rail has an exemplary sustainability program that is well funded from savings created by the business in conjunction with a crack team of sustainability professionals, which has led to past Clean50 Awards for both projects and individuals. And as transportation by rail offers significant GhG savings for shippers over trucks, we are delighted to have the support of an industry leader themselves, in recognizing sustainability leaders in the Manufacturing and Transportation category.

Bullfrog Power
---- The leading retailer of Green Energy in Canada, Bullfrog has greened the energy consumed at every Clean50 Summit since the first year, and has supported the larger Clean50 program itself for the 3 years.

Enwave Energy
--- Enwave operates Toronto's unique deep lake water cooling, that uses the cold waters of Lake Ontario to displace electricity and natural gas power and provide seasonal cooling to major buildings across Toronto, as well as a number of other district energy resources across North America.

Top Drawer Creative
--- Led by two time Clean50 / Clean16 Honouree, Howard Chang, who is also the winner of the 2017 Clean50 award as the most sustainable Independent business, Top Drawer Creative's team helps their clients refine and deliver their message to consumers across Canada. The firm counts the David Suzuki Foundation and WWF Canada among their clients, as well as both Bullfrog and Enwave.

Basic Contact Information for the NOMINEE
Please provide contact information for just the (first) nominee - NOT the person filling the form, if different (that comes later). Please note that to be named to the Clean50, the nominee will need to have at least some direct contact with the Selection Committee, if that person is on the short list of those people under final consideration for either the Clean50 or the Clean16. (If the nominee is not prepared to invest at least 15 minutes of their own time in that regard, please consider whether it is reasonable to nominate them....)
Nominee salutation / honourific
If the Nominee does not use an honourific, it DOES NOT need to be included - skip the question. If your nominee is a PhD and prefers to have their degree shown instead, please do not include "Dr." here (i.e. one or the other - not both)
First Name (commonly used) exactly as you would want it to appear in a press release *
If this nomination will be for a team, please enter only the first member / leader of the team. PLEASE DO NOT attempt to nominate 2 or more people and combine their names here - you may enter other names later. Do not include a middle initial, or use a long version of the name if the nominee typically uses the short version - i.e. Penelope vs Penny.
Your answer
Last Name (exactly as you would want it to appear in a press release) *
Your answer
Any letters which you wish to appear after the Nominee's name. If you already used an honorific of "Dr." then leave PhD off here.
i.e. Ph.D MBA etc
Your answer
Full Organization name (current organization) as you would want it to appear in the Globe and Mail. *
i.e Delta Management Group Inc. (not "DMG")
Your answer
Type of organization - which choice BEST describes the organization's primary status *
Nominee's Full Title (exactly as it should appear in a press release or on line) *
Your answer
Nominee's direct office phone number (no extension) *
Please enter in the format 416-234-5678
Your answer
Nominee's extension (if any)
Your answer
Email for the named nominee *
Your answer
Nominee's personal Email *
i.e. gmail / hotmail etc.
Your answer
Nominee's Mobile Number (include area code in the format 416-222-3333) *
Please include hyphens, but not brackets
Your answer
Organization Mailing Address - Line 1 *
Street number and name
Your answer
Address Line 2 - if needed
Include suite or box office number
Your answer
Address Line 3a - City or Town *
Your answer
Province or Territory - proper short form *
pick one of BC AB SK MB ON QC NB NS NL PE YT NT NU or if in the USA - State abrev plus USA i.e. MA USA
Your answer
Postal Code (6 characters, no space or hyphen) *
Your answer
Main Organization"Switchboard" number (Nominee's location) *
include area code, and hyphens (no brackets) in the format 416-222-3333
Your answer
Main Organization Website address *
starting from www. (no HTTP etc)
Your answer
Website address for organization's CSR or Sustainability report, if applicable (or answer N/A if none available) *
Please DO NOT cut and paste the whole report into this form. Please do not refer to the CSR Report in your answers in place of providing the answer, as an internet connection may not be accessible to the reviewer at the time of review. If applicable, we will review the report.
Your answer
Are you the Nominee? (i.e. the person named above) Or another person with full knowledge responding on their behalf? *
Please pick one of the two options
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