Provincial honours are a memorable and distinctive way for the government of Ontario to thank and pay special tribute to those Ontarians whose lives exemplify excellence and achievement of the highest order. The men and women we honour are truly representative of the province of Ontario’s caring and diverse society, and their lives and deeds stand as shining examples for us all.

In 1973, the government of Ontario established the Ontario Medal for Good Citizenship to recognize people who, through exceptional long–term efforts, have made outstanding contributions to the well being of their communities. Their assistance is given without expectation of remuneration or reward.

Nominees must be residents of Ontario. No elected federal, provincial or municipal representative may be awarded the Medal while such person remains in office. The Medal is not awarded for acts of bravery. Self–nominations will not be accepted. No person shall be awarded the Medal posthumously unless death occurs after his or her name has been selected by the Advisory Council.

An independent Advisory Council considers all nominations. The Lieutenant Governor of Ontario, is the Honorary Chair of the Advisory Council.

The Lieutenant Governor of Ontario presents recipients with a medal at a ceremony held in the Provincial Legislative Building. Award recipients are notified by phone in advance of the ceremony.

Nomination forms may be submitted at any time. The deadline is July 17 of each year. Nominations received after this date will be considered for the following year. Please send originals by mail or courier.

Additional information and nomination forms may be obtained by contacting the Ontario Honours and Awards Secretariatat at 416 314-7526 or visiting www.citizenship.gov.on.ca.

Mr.   Mrs.   Ms. Other Other
First Name   Last Name
Name of Organization
Position
Address   Business (9–5 pm) Home   Address
City/Town
Province   Postal Code
Telephone   Business (9–5 pm) Home   Telephone      Fax
E–mail 

Date of Birth (mm/dd/yyyy)
Month    Day    Year

Short description of achievement (maximum 10 words)

Is your nominee a resident of Ontario?
Yes  No  (specify)

Mr. Mrs. Ms. Other Other
First Name   Last Name
Name of Organization
Position
Address   Business (9–5 pm) Home   Address
City/Town
Province   Postal Code
Telephone   Business (9–5 pm) Home   Telephone      Fax No.
E–mail

Signature of Nominator
    Date

The completed nomination form signed by the nominator (including the 10 word summary).

Description of achievement (500 – 1000 words) describing:

•   an achievement which emphasizes and encourages the virtue of good citizenship by showing that the individual being nominated exemplifies that virtue;
•   the impact of the achievement and how the achievement enriched the lives of others;
•   what made this an outstanding achievement - indicate any extraordinary circumstances or challenges the nominee faced, if applicable include statistics or historical background;
•   how the nominee has touched the lives of others or their life;
•   examples of ongoing leadership and dedication;
•   how long you have known the nominee;
•   when the achievement was initiated and completed;

A minimum of (2) two signed testimonials from (2) two separate individuals, other than the nominator, who have direct knowledge of the value and impact of the achievement and who support your nomination. Please ensure that the contact information (address, telephone number and e–mail) for the testimonial writers is included in the letter.

Optional – additional material to support this nomination, such as additional testimonial letters (limit of (8) eight), publications, media stories, etc. Please list and label all material enclosed. Do not send videos or audio tapes. Do not send originals of important or official documents, as they will not be returned.

PLEASE NOTE: All materials MUST BE submitted unbound, on 8–1/2” x 11” paper and must be typed, reproduced or clearly handwritten.

Send the completed form and supporting material to:
Ontario Honours and Awards Secretariat
Ministry of Citizenship and Immigration
400 University Avenue, 4^th FLoor
Toronto ON   M7A 2R9

Completed nominations must be received by July 17 of each year.

For more information, contact the Ontario Honours and Awards Secretariat at 416 314–7526 or visit www.citizenship.gov.on.ca.