View - The Municipality of Lambton Shores

Lambton Shores Volunteer Appreciation Awards
Nomination Form (please print clearly)
In addition to the completed nomination form, supporting documents (i.e. reference letters,
newspaper articles, etc.) exemplifying the nominee’s outstanding achievements are welcomed.
Please note that any documents submitted will become the property of the Municipality of
Lambton Shores and will not be returned to the nominator or nominee. All supporting
documents must be printed clearly.
Nomination Category (select one):
□ Accessibility Award □ Good Neighbour Award □ Civic Award (25 and under)
□ Arts & Culture Award □ Heritage Award □ Civic Award (26 and older)
□ Environment Award
□ Sports and Recreation Award
** The Municipality of Lambton Shores may not present awards in all categories. The Selection committee
reserves the right to consider any nomination for other awards, if deemed appropriate.
Nominee Information:
Full Name:
________________________________________________________________
Mailing Address:
____________________________________________________
____________________________________________________
Daytime Phone Number:
Email:
____________________________________________________
____________________________________________________
I hearby allow my name to stand for nomination and consent to publication of my photograph
and information from my nomination package as applicable.
Signature:
________________________________________________________________
Print Name: _________________________________ Date: _______________________
Nominator #1 Information:
Full Name:
________________________________________________________________
Relationship to Nominee:
Mailing Address:
Daytime Phone Number:
____________________________________________________
____________________________________________________
____________________________________________________
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