Pioneers for Change 2015 | Nomination Form

Who Will Be Our New Pioneers? Help Us Find Out!

Do you know someone who champions the role of immigration in securing Canada’s prosperity, demonstrating the limitless potential of immigrants and the incredible impact they have in building prosperous, vibrant communities in Canada? If so tell us about them!

This year we will honour immigrants working to build a Canada where every immigrant succeeds with a focus on those working in the following categories: Arts, Women in Leadership, Innovation, Youth, Community Engagement, Outstanding Entrepreneurs.

Please fill in this short survey to submit your nomination.

Question Title

* 1. Nominee Name:

Question Title

* 2. Nominee Contact Information: Please provide an email address and phone number.

Phone

Question Title

* 3. I have informed my nominee of this nomination and they have agreed to having their named submitted for consideration.

Yes

Question Title

* 4. I am nominating this person for consideration under the following category:

Women in Leadership: Women taking an active role in their workplace, their community and/or personal lives, and in doing so supporting others in achieving their goals.

Arts: Nominees in this category will be immigrants who have achieved success in the arts, or who have advocated for or created access to the arts.

Innovation:This category is open to any immigrant who has championed innovation in some way - whether it be within their community, workplace etc.

Community Engagement: Nominees in this category are Immigrants working to give voice to all Canadians and to help newcomers fully participate and engage with their new communities.

Youth: Individuals or groups working to ensure immigrant youth have the tools and the confidence they need to become the great leaders or tomorrow or may be a youth/ group of youth that have achieved great things at a young age.

Entrepreneurship: Immigrants who have brought their passion and talents to Canada and created their own businesses to fuel our economy and provide needed goods and services.

Pioneers for Change 2015 | Nomination Form

Question Title

* 1. Nominee Name:

Question Title

* 2. Nominee Contact Information: Please provide an email address and phone number.

Question Title

* 3. I have informed my nominee of this nomination and they have agreed to having their named submitted for consideration.

Question Title

* 4. I am nominating this person for consideration under the following category:

Question Title

* 5. What 3 qualities does this person possess that make them a deserving candidate?

Question Title

* 6. Please tell us briefly why you believe this nominee is a Pioneer For Change:

Question Title

* 7. Has this person been recognized for their work in the past/ received any other awards?

Question Title

* 8. Please provide any relevant links that would help us learn more about the candidate - ie personal website, online articles, youtube videos etc.

Question Title

* 9. Your Name:

Question Title

* 10. Your Contact Information: Please provide an email address and telephone number where we can reach you.