2015 Nomination Form - World Vision International Peacemaker Award (Individual)

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The Peacemaker Award recognises an individual who has taken risks and excelled in being a catalyst in either bringing conflicted parties together to resolve a conflict or in enabling a peace process that engages peacemakers, mediators and people of moral authority who bring hope that a significant destructive conflict can be resolved..

Please enter the information below to nominate an individual for the peacemaking prize. All submissions must be done through this form. We recommend composing your text separately in a word processor and pasting the relevant sections into the form when you're done.

Names and contact information of the nominee, the nominator, and the referees, will remain private.

I am . . .

First, give the name and contact information of the person submitting the nomination (that's you!).

My Name *

Please enter your full name

My Email address *

for example: sister@peace.com

My Street Address *

for example: 777 Peace Street

My City/Town *

for example: Peacetown

My State or Province *

My Zip or Postal Code

My Country *

My Phone Number *

please include your country code, with a "+" in front, for example: +9100000000000

I am nominating . . .

Give the name and contact information for the person you are nominating for the Peacemaker award.

Nominee's Name: *

insert the name of the person you are nominating for Peamaker

Nominee's email address *

Nominee's Street Address *

Nominee's City/Town *

Organisation's State/Province *

Nominee's Zip or Postal Code

Nominee's Country *

Nominee's Telephone *

please include the country code, with a "+" in front, for example: +9100000000000

Nominee's Website

if they have one - for example: http://www.samlovespeace.net

Description of Peace Work

Kindly respond to the following questions in this form. Please make sure you limit the entries to the word limits where indicated.

Description of peacebuilding work of this individual that deserves nomination for the WVI Peace Prize according to the criteria found in the guidelines available at: www.wvi.org/peaceprize

Description of specific project, practice, or technique *

1000 words maximum

Description of organisation that individual is associated with, the history and scope of its work or how the individual partners with others: *

1000 words maximum

Describe the context in which the individual works, analyse the conflict, and indicate how this analysis has influenced the peacemaking work of the individual: *

1000 words maximum

Impact of the individual's work, including credible policy and advocacy influence that contributes toward peace: *

1000 words maximum

Tell us a story about this individual's peacemaking work: *

1000 words maximum

Referees

List three people who are willing to give informed judgments of the worthiness of this nominee.

Referee 1: First and last name *

Referee 1: Relationship to Nominee *

for example: This person supported the nominee financially

Referee 1: Email address

please enter the email address where this person can be contacted

Referee 1: Telephone *

please enter the number we can reach this person - please include country code: e.g. +1.202.555.1212

Referee 1: Street Address *

Referee 1: City/Town *

Referee 1: State/Province *

Referee 1: Country *

Referee 2: First and last name *

Referee 2: Relationship to Nominee *

for example: This person was a donor to this organisation

Referee 2: Email address

please enter the email address where this person can be contacted

Referee 2: Telephone *

please enter the number we can reach this person - please include country code: e.g. +1.202.555.1212

Referee 2: Street Address *

Referee 2: City/Town *

Referee 2: State/Province *

Referee 2: Country *

Referee 3: First and last name *

Referee 3: Relationship to Nominee *

for example: This person was a donor to this organisation

Referee 3: Email address

please enter the email address where this person can be contacted

Referee 3: Telephone *

please enter the number we can reach this person - please include country code: e.g. +1.202.555.1212

Referee 3: Street Address *

Referee 3: City/Town *

Referee 3: State/Province *

Referee 3: Country *

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