Peter Henderson Bryce Award Nomination Form

First Name

Last Name

Profession

Affiliation - Employer / volunteer / group

Nominee's Email Address

NOMINEE'S TELEPHONE NUMBER

Country

Address Line 1

Address Line 2

City/Town

Province

Postal code

First Name

Last Name

Email Address

Telephone

Country

Address Line 1

Address Line 2

City/Town

Province

Postal code

How do you know of the nominee’s advocacy work?

How long have you known the nominee?

Cover letter explaining how the nominee meets the award criteria

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One file only.
100 MB limit.
Allowed types: pdf jpg jpeg png tiff doc docx.

2 letters of support

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100 MB limit.
Allowed types: pdf, jpg, jpeg, png, tiff, doc, docx.

Photos in support of the nomination

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Maximum 10 files.
100 MB limit.
Allowed types: pdf gif jpg jpeg png tiff.

Other documents in support of the nomination

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One file only.
100 MB limit.
Allowed types: pdf jpg jpeg png tiff doc docx.

Other websites / urls that might support the nomination (links to video clips, pictures, etc)

Other websites / urls that might support the nomination (links to video clips, pictures, etc)
Other websites / urls that might support the nomination (links to video clips, pictures, etc) Link URL