Denney Photography: Jonathan Bielaski, Light Imaging
Nomination Form

Nomination Period Now OPEN!

2011 Nomination closing date is Friday, December 16, 2011

Please read Nomination Criteria Click

 
Person/Organization being nominated
*Name
*Address
*City
*Postal Code
*Email
*Day Phone Number
Evening Phone Number
Artistic Discipline (select one)
* Literary: Includes all forms of creative writing, fiction, non-fiction, poetry, prose, etc.
Performing Arts: Includes theatre, dance, mime, musical, artistic or technical direction, etc.
Visual Arts: Includes painting, sculpture, multi-media, film, photography, etc.
Open: Includes administrator, arts supporter, volunteer, etc.
Music: Includes musical performance, composition, conducting, etc.
Mentor: Includes educator, instructor, leader, etc.
Leading Edge: any arts discipline; under 25 years of age.
Textile, Fibre, Quilting Arts
Festival or Event
New Festival or Event
Festival or Event Volunteer
Age on December 31, 2010 for Leading Edge Discipline (if applicable)
*Indicate number of years the nominee has made a contribution to the Arts in the Region of Waterloo
Nominator (must be an individual, cannot be an organization, family member, co-habiting partner, and, when the nominee is an organization, cannot be a board or staff member of the organization)
*Name
*Address
*City
*Postal Code
*Home Email
*Home Phone Number
Would you prefer to remain anonymous?
Endorser (must be a different person than the nominator, must be an individual, cannot be an organization, family member, co-habiting partner, and, when the nominee is an organization, cannot be a board or staff member of the organization)
*Name
*Address
*City
*Postal Code
*Home Email
*Home Phone Number
Would you prefer to remain anonymous?
*Please include a description of the nominee's contribution to the arts in the Region of Waterloo and why you believe the nominee would be a worthy recipient of an Arts Award.
Nominee will be asked to supply relevant supporting materials.
Email addresses will be used for future correspondence for the sole purpose of promoting and administering the Arts Awards.
Note: make sure you complete all required information marked above with *
Enter Nothing:
* Red star indicates required fields
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