Victoria Community Leadership Awards 2019 Nomination Form
Your name *
Your answer
Your Phone Number *
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Your Email Address *
Your answer
Who are you nominating?
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Their Phone Number
Your answer
Their Email Address
Your answer
Does this leader know what you are nominating them?
150 word biography of your nominee *
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What organization or project is this leader primarily associated with? *
Your answer
Is this Leadership part of their employment? *
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What Category best describes this Leader's Contribution? *
Why are you nominating this leader?
Your answer
Tell us about the community problem your nominee is working to solve. Share the details. *
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What group of people has been positively impacted by the community leadership of your nominee?
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What problem is being solved by this Leadership?
Approximately, how many people have been impacted by this leadership? *
Your answer
What geographic area(s) in the Capital Region are affected/benefited by the community leadership of this person?
What Challenges has this Leader Overcome? *
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Is there anything else we should know?
Names, email address, and phone numbers of two people who have been positively impacted by this nominees leadership.
Your answer
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