June Callwood Award - Circle of Outstanding Volunteers

Each hospice in Ontario that holds a current HPCO organizational membership is invited to nominate one volunteer from within their organization who exemplifies the spirit of hospice volunteerism. Nominees will be inducted into the June Callwood Circle of Outstanding Volunteers at the HPCO Annual Conference.

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* 1. Your Contact Information (Nominator)

Name

Hospice Name

Hospice Address

City/Town

Province

Postal Code

Email Address

Phone Number

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* 2. I confirm that the Board Chair or Executive Director of our hospice has approved this nomination.

Yes

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* 3. Executive Director Information

Executive Director's Full Name

Email Address

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* 4. About the Nominee

Nominee's Full Name *

Address *

Address 2

City/Town *

Province *

Postal Code *

Email Address *

Phone Number *

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* 5. Nominee Name - Phonetic Pronunciation

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* 6. Years of Service with the Organization

100

Clear

i We adjusted the number you entered based on the slider’s scale.

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* 7. Provide a paragraph about the Nominee to be included in the award booklet. (maximum 100 words. Entries exceeding 100 words may be edited for length by HPCO)

June Callwood Award - Circle of Outstanding Volunteers