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Senior Volunteer Award Nomination Form (For Individual)
(If you are nominating from an organization,
please submit via this link.
)
Nominate a senior volunteer
Please submit by Friday May 26
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* Indicates required question
Email
*
Your email
Nominator Information
First Name
*
Your answer
Last Name
*
Your answer
Email
*
Your answer
Phone Number
*
Your answer
Contact Person
*
Your answer
Award Recipient's Information
Award Recipient's First Name
*
Your answer
Award Recipient's Last Name
*
Your answer
Award Recipient's Age (Must be 65 or older)
*
Your answer
Award Recipient's Address (Must be in Markham-Unionville)
*
Your answer
Award Recipient's Email
Your answer
Award Recipient's Phone Number
*
Your answer
Brief Description of Recipient's Volunteer Activities
*
Your answer
Language Spoken (check all apply)
*
English
Mandarin
Cantonese
Required
A copy of your responses will be emailed to the address you provided.
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