EKO - Service Award

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Please provide all required information by completing the form, or by attaching an audio or video file.

If you are nominating a team, please list all members and describe how they work collaboratively to benefit the child development and rehabilitation sector, and kids with disabilities and their families specifically.
Attach endorsement/s. One endorsement is required, up to four are permitted. Endorsements can be provided as Word documents or PDF, as audio files, or as video files (max 500 MB).
The nomination statement and endorsements may be provided in Word or PDF, or as audio files or video files (max 500 MB).
You must choose Submit to complete the nomination before the deadline. The Tribute Awards Review Committee will not review draft nominations.

Do you have accessibility needs that are not being met? Let us know how we can help—please contact us at info@empoweredkidsontario.ca.

Service Award

Nominator Information

Name

Organization

PhonePhone PrefixPhone Line NumberPhone Extension

ext.

Relationship to the Nominee

Nominee Information

Name of the individual/s or organization nominated

Contact email (for nominations of teams, please provide contacts for each team member)

Nomination Highlight (if written, 50 words)

Nomination Statement (if written, 500 – 1000 words)

Endorsers

List names and emails for each endorser

Endorsements

File Upload

If the nomination is successful, may we tell the candidate/organization that you were the nominator?

If the nomination is successful, may we tell the candidate/organization that you were the nominator?Yes
No