Thank you for your participation in this important YMCA initiative!

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* 1. Category

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* 2. Name

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* 3. Group/Organization Name (if applicable)

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* 4. Is the nominee paid a wage/salary for their peace-keeping? 

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* 5. City

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* 6. Email

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* 7. Phone Number

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* 8. Nominator Name

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* 9. Nominator Email

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* 10. Nominator Phone Number

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* 11. Are you (the nominator) and the nominee available to attend the YMCA Peace Breakfast and Peace Medal Award Ceremony on Thursday, November 22, 2018?

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* 12. Why did you choose to nominate this individual/group, and how have they inspired you and others through their acts of peace? 

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* 13. Describe in detail how this individual/group is seeking innovative solutions to violence, discrimination, injustice, and community cohesion. 

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* 14. What was the nominee's specific role and responsibility in performing the above? 

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* 15. Please summarize the nominee's impact in creating peace on individuals and/or the community, by referring to the PEACE acronym on the previous page. Be as specific as possible (i.e. number of people involved, amount of time, list of outcomes, funds raised, etc.)   

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* 16. Describe how any peace work initiatives create(d) long-term, sustainable impact on individuals or the community.

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* 17. Highlight any collaboration with any other individuals or groups. 

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* 18. Highlight any challenges or obstacles the nominee faced, and how they overcame them. 

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* 19. How did you learn about the YMCA Peace Medal nominations?

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* 20. If you have any supporting documents or photographs to include, please email vidaro@oakville.ymca.ca, and indicate what file(s) you are including.

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