NOMINATION FORM

(to be filled in by nominator)

NOMINEE’S NAME

 

ADDRESS:

 

TELEPHONE NUMBER: RESIDENCE

AFFILIATION

BUSINESS

 

NOMINATOR'’S NAME (or organization)

 

 

ADDRESS:

 

TELEPHONE NIWMBER: a REST ENCE

Category
(please indicate category chosen)

BUSINESS

 

A) DR.NORA LOZOVSKY AWARD

 

B) DR. WILLIAM BLACK AWARD

 

C) PUBLIC SERVICE AWARD

 

D) HUMANITARIAN AWARD

This is to confirm that permission for nomination has been received from the person whom I/we

nominated.

 

Signature and title (when applicable)

 

 

Signature and title (when applicable)

NOMINATION PROCEDURE

1) Nomination forms must be accompanied by a short biography and a statement highlighting the
specific achievements or contributions made by the nominee in the award category indicated.
Other supporting material such as letters of support and reference, clippings etc. may also be

included.

2) Nominations made by associations, organizations or groups must be signed by at least two

members of their executive.

3) MAIL COMPLETE NOMINATION FORM AND SUPPORTING DOCUMENTATION TO:

THE AWARDS COMMITTEE

VANCOUVER MULTICULTURAL SOCIETY
1254 WEST 7TH AVE,

VANCOUVER, B.C.

VOH 1B6

4) DEADLINE FOR NOMINATIONS: 5:00 p.m. OCTOBER 1, 1985.

June 1985