cvfsa lifetime acievement award nomination form · cvfsa lifetime achievement award – nomination...
TRANSCRIPT
Nomination Form for CVFSA Lifetime Achievement Award
CVFSA Business Office 5-2600 Skymark Ave., Suite 100, Mississauga, Ontario L4W 5B2 Phone toll free: 1-877-920-2111 – Email: [email protected]
The Canadian Volunteer Fire Services Association annually honors a volunteer firefighter or fire officer whose outstanding achievements in the fire service and community exemplify the duties of a firefighter. Nominated by their peers, the recipients are awarded a plaque and a place in history within the Canadian fire fighting community.
Nominations must be received by June 7th, 2019. To nominate a volunteer firefighter for the CVFSA Firefighter Lifetime Achievement Award, fill out the form below and attach the nominee's resumé or background sheet, letters of recommendation, and any other supplemental material that will be helpful during the selection process. You may email this completed PDF, or a printed and scanned copy, to [email protected].
For more information, contact: Mr. Mark Pound, Chairperson Phone: 902-678-2786 or email at: [email protected]
Step One: Nominee Information
Full Name: _____________________________________________________
Address 1: _____________________________________________________
Address 2: _____________________________________________________
City: _____________________________________________________
Province: _____________________________________________________
Postal Code: ____________________
Phone Number: ______________________________________ XXX-XXX-XXXX
Email Address: _____________________________________________________
# of Years Service: __________ (must have a minimum of 20 years volunteer service)
Citizenship: _____ Canadian _____ Non-Canadian
CVFSA Lifetime Achievement Award – Nomination Form Page 2 of 3
CVFSA Business Office 5-2600 Skymark Ave., Suite 100, Mississauga, Ontario L4W 5B2 Phone toll free: 1-877-920-2111 – Email: [email protected]
Was the nominee's work done as a volunteer? If the nominee was paid, please explain:
Describe the nominee's work in the area of firefighting, fire education or prevention, medical first responder, fire service instructor, arson investigation or enforcement, or legislation promoting fire safety:
Please explain the reasons you feel this candidate should receive this award:
CVFSA Lifetime Achievement Award – Nomination Form Page 3 of 3
CVFSA Business Office 5-2600 Skymark Ave., Suite 100, Mississauga, Ontario L4W 5B2 Phone toll free: 1-877-920-2111 – Email: [email protected]
Step Two: INFORMATION ABOUT THE PERSON FILLING OUT THIS FORM
Full Name: _____________________________________________________
Address 1: _____________________________________________________
Address 2: _____________________________________________________
City: _____________________________________________________
Province: _____________________________________________________
Postal Code: ____________________
Phone Number: ______________________________________ XXX-XXX-XXXX
Email Address: _____________________________________________________
• Attachments
Please include with your submission a resumé or background sheet and letters ofrecommendation:
• Nominee's resumé/background sheet .*.• Letter of recommendation 1 .*.• Letter of recommendation 2 .*.• Additional supporting documentation (optional)
• Nomination submissions must include:
• This form• Detailed resumé or background sheet containing an overview of the nominee's experience,
education, or other pertinent information• Letters of recommendation supporting the nominee• _____________________ name of municipal official (Mayor, Councillor, etc.) who knows
this individual and the work they have done within the community.
If mailing your application, send to our business office AND mark your envelope on the outside
ATTENTION: Lifetime Achievement Award Canadian Volunteer Fire Services Association 5-2600 Skymark Ave., Suite 100Mississauga, Ontario L4W 5B2
Email: [email protected]