Required fields are marked with an asterisk (*)

Volunteer Awards 2023
Adult Award Nomination Form

Nominator’s Information *

Volunteer’s Information *
Name as it will appear on certificate - please ensure the spelling is correct.

Volunteer’s Role & Organization information
Example:
  • Role: Treasurer
  • Organization: ABC Community Association
  • Purpose of Organization: To enhance, engage and represent our diverse neighbourhood, where we live, work and play, by  facilitating partnerships, programs and services.
  • Number of Years Volunteering With Organization: 20 years

Volunteer’s Contribution
(Please write in point form)

Volunteer’s Impact
(Please write in point form)

Provide 2-3 sentences that outline the nominee’s volunteer involvement, which can be read during the ceremony and used in the event program.

Please sign above.

In accordance with Section 485 of the Municipal Government Act (MGA), the personal information collected on this form will only be used for purposes relating to the Volunteer Award’s nomination, selection and announcement process or as otherwise consented to herein.

If you have any questions about the collection and use of this information, please contact the municipal Access and Privacy Office at 902-490-4390 or accessandprivacy@halifax.ca