6th Annual Lieutenant Govenor's Awards for Public Safety Nomination Form

Submitted by JenniferLee on 2 July 2010 - 3:39pm

The Lieutenant Govenor's Awards for Public Safety have honoured individuals and organizations that make our communities and workplace safer.

Nominator's first name: *

Nominator's last name: *

Nominator's organization:

Nominator's address: *

Nominator's city: *

Nominator's province:

Nominator's postal code: *

Nominator's telephone number: *

Nominator's email: *

Award category: *

Your nominee (first name, last name, or organization): *

If your nominee is an individual, please provide their organization's name:

Nominee's address:

Nominee's city:

Nominee's province:

Nominee's postal code:

Nominee's telephone: *

Nominee's email:

Nomination description:

Please provide a one-page description of the reasons the individual or organization should be considered for an award.

Nomination profile:

Please provide a one-page personal biography or corporate profile.

Supporting letter of reference # 1:

Please attach a letter supporting the nomination.

Supporting letter of reference # 2:

Please attach another letter supporting the nomination.

Additional supporting document (optional):

Please provide up to three-pages of additional information or supporting document for your nomination.

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