Volunteer Awards Nomination Form

I/We wish to place the following nomination before the Recognition Committee:

Nominee's Information:

(Information provided will be used for presentation purposes, therefore, details must be accurate.)
Name:
TSFC Affiliation (if any):
Address:
City:
Province:
Postal Code:
Phone:
Email:

 

When did the service occur? (Service must have been performed in the year immediately preceding the annual conference at which the award will be presented (the one-year period running from July 1st to June 30th).

 

Is the contribution a single project or a continuing contribution? Please explain.

 

Describe the overall benefit(s) and/or impact to the Tourette community at a NATIONAL level.

 

Please provide highlights of your nominee, achievement(s) you wish recognized and how they met the criteria as outlined.

 

Please provide any other details that would assist us with this nomination.

Nominated by:
Name:
TSFC Affiliation (if any):
Address:
City:
Province:
Postal Code:
Phone:
Email:
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