The purpose of the award is to recognize and honour outstanding seniors who, after age 65, have made significant contributions to their communities. The outstanding voluntary or professional achievement may have occurred in any field of endeavour. Each year, 20 individuals are selected to receive this prestigious award.
To qualify for an Ontario Senior Achievement Award the nominee must be a resident of Ontario and have made a significant contribution after age 65 in one or more of the following categories:
The award recipients are selected by an independent selection committee made up of representatives from the seniors’ community. The committee reviews the submissions and selects the 20 recipients from the numerous nominations received. Nominations may be made by any person or organization wishing to recognize outstanding seniors in their community.
October 1 is the International Day of Older Persons. The awards will be presented at a special ceremony held at Queen's Park in October. The 20 recipients and their nominators will be notified by telephone in advance of the awards ceremony.
Nomination forms may be submitted at any time. The deadline is June 15 of each year. All nominations received after this date will be considered for the following year. Photocopies of this form are also acceptable.
Posthumous and self-nominations will not be accepted.
Further information and additional nomination forms may be obtained from: Ontario Honours and Awards Secretariat Ministry of Citizenship and Immigration 400 University Avenue, 4th Floor Toronto ON M7A 2R9 Telephone: 416 314-7526 Fax: 416 314-7743 Or visit our website at www.citizenship.gov.on.ca
Personal information on this form is collected under the authority of the Ministry of Citizenship and Culture Act, R.S.O. 1990, c.M.18, s.4 and will be used to determine eligibility and to notify recipients of the Senior Achievement Awards. For further information, please contact the Ontario Honours and Awards Secretariat, 400 University Avenue, 4th Floor, Toronto ON M7A 2R9 Telephone: 416 314–7526.
PLEASE PRINT CLEARLY AND COMPLETE IN FULL
Title First Name Last Name Name of Organization Position Address City/Town Province Postal Code Telephone No. (9:00 am to 5:00 pm) Fax No. E–mail
Title First Name Last Name Name of Organization Position Address City Province Postal Code Telephone No. (9:00 am to 5:00 pm) Fax No. E–mail
Is nominee aware of this nomination? Yes No
Signature of Nominator Date
In addtion to completing the form, please see below for additional material to be included in your submission.
In addition to completing the form found above, please provide a brief description of your nominee’s activities and the contribution he or she has made. Please note that the selection of award recipients is based solely on information provided in the nomination package. It is therefore important that all materials in the package be complete.
Arts/Literature Community Service Education Environment/Science Fitness/Recreation/Sports Humanitarian Activities Preservation of History Voluntarism Other (please specify)
a) Describe the achievement in detail, including any background or historical information related to the achievement. b) Describe what made this an outstanding achievement for your nominee, including any extraordinary circumstances or challenges the nominee faced. c) Describe how this achievement has touched the lives of others or the life of the senior being nominated. d) Indicate how long you have known the nominee. e) Indicate when the achievement was initiated and completed.
Testimonials should be current and from persons who can attest to the value and impact of the achievements of the nominee.
List any additional material provided to support this nomination. For example, additional testimonial letters, publications, media stories, etc.
NOTE: Please submit materials in 8.5" x 11" format. Do not send originals of importance or official documents, as they will not be returned.
Please submit signed nomination form and support materials to:
Ontario Honours and Awards Secretariat Ministry of Citizenship and Immigration 400 University Avenue, 4th Floor Toronto ON M7A 2R9
DEADLINE: Completed forms must be received by June 15
61–176(11/07) ©Queen’s Printer for Ontario, 2007