Nomination Form

GUELPH - WELLINGTON BARRIER FREE COMMITTEES

ADVISORY ~ EDUCATION ~ RECREATION ~ TRANSPORTATION

Guelph-Wellington Access Recognition Awards

2007

Please check the award(s) for which you are nominating this individual, group or business (please refer to eligibility criteria):

Outstanding Contribution - Business

Outstanding Contribution - Community Group

Outstanding Contribution - Educator

Outstanding Contribution - Individual - Adult (18 yrs and older)

Outstanding Contribution - Individual - Youth (under 18 yrs)


For Persons living with a Disability:

Outstanding Accomplishment - Adult (18 yrs and older)

Outstanding Accomplishment - Youth (under 18 yrs)


In which area is your nominee geographically located:

Wellington County City of Guelph


Nominee Information:


Name: __________________________


Title (if applicable): ____________________


Address:_________________________________________________


Postal Code: ___________


Phone #: ____________ Email: ______________


Have you contacted the nominee regarding their nomination?


Yes _____ No _____


Nominated By:


Name: __________________________


Title (if applicable): ____________________


Address:________________________________________________


Postal Code: ___________


Phone #: ____________ Email: ______________



The following information is required to select our award recipients.

A detailed description of the nature of the accomplishment or contribution in the form of a letter (Maximum one page 8 ½ x 11) Please explain in detail why you feel the award is deserved.

Please include any support documents (i.e. newspaper article, letter etc). 

Please mail, phone or fax your nomination by Friday April 20, 2007 to:

Access Recognition Awards, c/o Administrator of Disability Services

City Hall, 59 Carden St., Guelph, ON N1H 3A1


Please photocopy and distribute these forms as necessary. Feel free to nominate more than one individual or group per category or to nominate an individual or group for more than one category.

For more information, please call Leanne Warren 837-5618 ext 230, TTY: 826-9771. 


Thank you for supporting us in the recognition of Barrier Free Access

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