2024 Volunteer Award of Merit Nomination Form

An individual, team, group or business who is currently contributing to the betterment of the local community and Georgina as a whole.

Each section of this nomination form must be completed in order to be considered. Should you have questions or require additional information, contact:

Recreation Services Division

905-476-4301

eleisure@georgina.ca

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* 1. Award Category: Indicate which award catagory you are nominating for by placing a check mark in the appropriate box.

Individual

Group/team

Youth

Business

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* 2. Eligibility: Confirm eligibility requirements of the individual, team, group or business by placing a checkmark in each box.

The nominee(s) is/are residents of Georgina.

The nominee(s) has/have contributed to the betterment of their local community or Georgina as a whole (includes recognizing individuals for community events).

Nominee(s) is/are not an elected official or a staff member of the Town of Georgina as of the nomination deadline.

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* 3. Nominator Information: Provide your contact information.

First and Last Name

Address

City/Town

Province

Postal Code

Email Address

Phone Number

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* 4. Nominee Information: Provide the name and contact information of the individual you are nominating. If you are nominating a team/group/business, provide a name for the team/group/business, the number of people in the group, and the name and contact information of the person recognized as the team/group/business’ representative.

Name of the team, group or business (if applicable).

Number of people in group

First and Last Name *

Address *

City/Town *

Province *

Postal Code *

Number of people in team, group or business

Email Address *

Phone Number *

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* 5. Role: Provide an overview of the contribution(s) the nominee(s) has/have made to make the community stronger, how they have brought about community-wide benefits, or how they have shown leadership to help their community.

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* 6. Impact: Describe how the nominee(s) has/have made a difference in the community. (For instance, describe how the nominee's actions have made an impact on individuals, groups or the community as a whole).

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* 7. Reach: Describe who has benefited from the nominee's contributions (whether they are individuals, groups or their community as a whole). Also point out the relevance and importance of the benefits generated by helping these individuals or groups.

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* 8. Engagement: Describe how the nominee's contributions to the community prompted teamwork amongst others.

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* 9. Challenges: Describe how the nominee(s) has/have overcome challenges to make a contribution in their community.

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* 10. Inspiration: Describe how the nominee(s) has/have become a role model to others in the community or within their team/group/business.

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* 11. How did you learn about the Town of Georgina's 2024 Volunteer Award of Merit?

Town of Georgina's Website - georgina.ca

Newspaper

Social Media (Facebook, Twitter, Instagram, etc.)

Local business/community organization

Other (please specify)

Thank you for taking the time to complete this nomination form. Completing the nomination process shows your commitment to strengthening volunteerism in Georgina and your recognition of the significant contributions volunteers make to improve the well-being of families and communities.