Recognizing people who make a positive difference in the lives of Alberta s seniors Nomination Deadline: May 19, 2017

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Recognizing people who make a positive difference in the lives of Alberta s seniors Nomination Deadline: May 19, 2017 www.seniors-housing.alberta.ca

2017 Minister s Seniors Service Awards Message from the Honourable Lori Sigurdson Minister of Seniors and Housing I am delighted to welcome nominations for the 2017 Minister s Seniors Service Awards. For the past two decades, these awards recognize individuals and organizations that volunteer to support seniors. There are many people and groups who volunteer their time and energy to support seniors in so many ways. These are exceptional Albertans who enthusiastically volunteer countless hours to teach computer skills to seniors, prepare delicious meals for special occasions or, day after day, settle in behind the wheel to make sure seniors get to their important appointments on time. All of these volunteer tasks matter and it is important for us to recognize and say thank you to those who dedicate their time and talents to improve the lives of seniors. This year, I am pleased to announce the inaugural Alice Modin Award as part of the Minister s Seniors Service Awards. Alice Modin started a campaign to launch a seniors day in Strathcona County about 30 years ago that helped pave the way for a provincewide Seniors Week. The Alice Modin Award will honour a senior who has provided longterm volunteer service to their community, promotes volunteerism by or for seniors, or whose volunteer efforts have had a provincial impact. General Information: The Minister s Seniors Service Awards recognize individuals and organizations who volunteer to support seniors in Alberta. There are three award categories: 1. Individual (any age including 65 years or older) 2. Organization 3. Alice Modin Award (20 years or more of volunteer service and 65 years or older) Please review the criteria under each category, complete the appropriate form, tear it off and provide it along with the rest of your nomination package (letters, summary of volunteer activities and other materials). Please note the following: Only one nomination form is required per nominee. The nominee must sign the nomination form. Without consent, the nominee cannot be considered for this award. Nominations may include photographs, newsletters, certificates and other supporting materials. Any materials provided will become the property of Alberta Seniors and Housing and will not be returned. All supporting documents should be provided in English or provide an English translation. Please take the time to nominate a person or organization. All nominees will be recognized at special community celebrations held all over the province in the summer. Recipients will be recognized in the fall. Thank you to all volunteers who support seniors. You make a difference in the lives of Alberta seniors. Lori Sigurdson Minister, Seniors and Housing MLA, Edmonton-Riverview 2016 Award Recipient Alaire Oberg with Minister Sigurdson and Emcee Dr. Bob Turner, MLA Edmonton-Whitemud

1. Individual Nomination Criteria The nominee must be an Alberta resident of any age including those 65 years or older who provides volunteer services to seniors in Alberta. Couples may be nominated in the individual category. Please ensure that both persons have signed the nomination form and provide both addresses if the nominees reside separately. Summary of Volunteer Activities Provide a summary of volunteer activities to capture all of the volunteer work the nominee does with seniors. Please include: Where the individual volunteers. The type of volunteer work (e.g. driving, home/ maintenance services, entertainment, etc.). The number of volunteer hours (can be weekly, monthly or yearly). Who has benefited from the service (e.g. individual seniors, the community, dementia patients, etc.). The number of seniors served through the volunteer service (if applicable). Additional information or details. This is the place to add descriptions of the work and any other relevant information. Consider providing this information in a table format, like the one below as an example. Letters of Support (2 to 5 letters are recommended) Letters of support are the best way to demonstrate the impact of the volunteer s work with seniors. These letters should: Be written by those benefiting directly from the volunteer service provided by the nominee, or written by someone with detailed knowledge of the nominee s volunteer service. Provide details of the service the volunteer provides and include, if possible, how often the volunteer provides this service (if not already included in a summary of volunteer activities). Outline how seniors benefit from the service provided. SAMPLE SUMMARY OF VOLUNTEER ACTIVITIES Volunteer service provided Where Service provided to Number of seniors served Number of volunteer hours Additional information/ details Bingo caller Seniors Center Members at centre 30 3 hours/week. Total of 468 hours since 2014 Drive seniors to medical appointments Seniors 4 20 hours/month since 1998

2017 Minister s Seniors Service Awards Individual Nomination Form Salutation: Mr. Ms. Mrs. Other Nominee: Home Address: The personal information collected on this form is collected under s. 33(c) of the FOIP Act and will only be used and disclosed to determine the Nominee s suitability and eligibility to receive the Minister s Seniors Service Award and for other reasonably related administrative purposes in accordance with the FOIP Act. If I am selected for an award, I hereby freely consent to the disclosure, as the Ministry deems appropriate, of my name, address, phone number, and any information provided as part of this nomination package, to interested parties including the media for interviews, stories and follow up. I hereby give permission to the Government of Alberta to use my material (photograph, video, name or quotation) without any compensation to me. I understand this material will be used in communication and materials about Government of Alberta programs and services and they will be distributed to the public through a variety of means, including printed and electronic communications. All government communications where this material will appear shall constitute the property of the Government of Alberta, solely and completely. I understand that the material may be used by or licensed to other public bodies and private companies for use in materials in promoting the province of Alberta. I waive all moral rights, claims, and objections arising from the use of this material, worldwide and in perpetuity, in favour of the Government of Alberta, its agents, employees, and contractors. If I have questions regarding my consent or the use of my information, I can contact Communications with Alberta Seniors and Housing by phone at, 780-644-5678, or by mail at 44 Capital Blvd, Third Floor, Edmonton, AB T5J 3S7. Signature Date Nominator Information (The person who would be the best contact to reach for questions about the nominee or the nomination package.) Name: Address: Nomination Deadline: May 19, 2017

2. Organization Nomination Criteria An Alberta organization that: Is not for profit, and Relies on volunteers to support seniors. Nominations must include a summary of organization information, letters of support, and a signed nomination form. Summary of Organization Information To ensure your nomination is as detailed as possible, include a summary with the following information (if applicable): Letters of Support (2 to 5 letters are recommended) Letters of support are the best way to demonstrate the impact of the organization s service to seniors. Letters of support should be written by someone with detailed knowledge of the organization s programs and services or someone benefiting from the services. Letters of support can include information outlined in the organization summary. Date (year) the organization was established. Organization purpose or mission statement. Number of staff. Number of volunteers. How volunteers within the organization are used to assist/benefit seniors. The number of seniors that benefit from the services the organization provides. List of services/programs/events provided by the organization, including a description of each, frequency, and how long the service has been provided. Special initiatives or projects, including a description. Note: The summary can be provided by a member of the organization including the Executive Director or President. 2016 Award Recipient South East Edmonton Seniors Association with Minister Marlin Schmidt, MLA Edmonton-Gold Bar and Minister Lori Sigurdson, MLA Edmonton-Riverview

2017 Minister s Seniors Service Awards Organization Nomination Form Organization: Salutation: Mr. Ms. Mrs. Other Representative Name: Representative Title: Organization Address: The personal information collected on this form is collected under s. 33(c) of the FOIP Act and will only be used and disclosed to determine the Nominee s suitability and eligibility to receive the Minister s Seniors Service Award and for other reasonably related administrative purposes in accordance with the FOIP Act. If I am selected for an award, I hereby freely consent to the disclosure, as the Ministry deems appropriate, of my name, address, phone number, and any information provided as part of this nomination package, to interested parties including the media for interviews, stories and follow up. I hereby give permission to the Government of Alberta to use my material (photograph, video, name or quotation) without any compensation to me. I understand this material will be used in communication and materials about Government of Alberta programs and services and they will be distributed to the public through a variety of means, including printed and electronic communications. All government communications where this material will appear shall constitute the property of the Government of Alberta, solely and completely. I understand that the material may be used by or licensed to other public bodies and private companies for use in materials in promoting the province of Alberta. I waive all moral rights, claims, and objections arising from the use of this material, worldwide and in perpetuity, in favour of the Government of Alberta, its agents, employees, and contractors. If I have questions regarding my consent or the use of my information, I can contact Communications with Alberta Seniors and Housing by phone at, 780-644-5678, or by mail at 44 Capital Blvd, Third Floor, Edmonton, AB T5J 3S7. Signature Date Nominator Information (The person who would be the best contact to reach for questions about the nominee or the nomination package.) Name: Address: Nomination Deadline: May 19, 2017

3. The Alice Modin Award In 1985, Strathcona County resident Alice Modin lobbied county council to declare an annual seniors day, which expanded to a week-long celebration, first recognized as Seniors Week by the Government of Alberta in 1986. Prior to her passing in 2014, Alice was a strong advocate for seniors, passionate about local history, and was a consummate community volunteer. She volunteered at the Mannville Five Point Women s Institute and the Sherwood Oaks Senior Citizens Association some years ago. Alice s hard-working nature was an asset for soldiers during the war, when she and other ladies prepared gift boxes to send to local soldiers. In 1999, Alice received the Minister s Seniors Service Award in recognition of her outstanding volunteer services in support of seniors. In 2011, she was recognized by the International Women s Day committee in Strathcona County for making a difference in her community. In recognition of Alice s contributions to Alberta through the establishment of Seniors Week, and her long-standing volunteer and charitable efforts in her community, the Alice Modin Award is being introduced as a new category of the Minister s Seniors Service Awards in 2017. Criteria An individual Albertan or couple who: Is 65 years of age or older and has been volunteering in their community for 20 or more years (not all years necessarily in direct support of seniors). Actively promotes volunteerism amongst seniors or in support of seniors, and/or Has had a provincial impact for seniors through their volunteer efforts. Summary of Volunteer Activities Provide a summary of volunteer activities to capture all of the community volunteer work the nominee does. Please include: Where the individual volunteers. The type of volunteer work (e.g. meal delivery, music lessons). How long they have been volunteering. Who has benefited from the service (e.g. seniors, youth, the community). SAMPLE SUMMARY OF VOLUNTEER ACTIVITIES Volunteer service provided and where Service provided to Number of years volunteering Additional information Coordinate seniors to volunteer at boys and girls club community at large, youth since 1978 Letters of Support Letters of support are the best way to demonstrate the impact of the volunteer s work. These letters should: Be written by those who benefited directly from the volunteer service or someone with detailed knowledge of the volunteer service. Provide details of the volunteer service and the positive impact on the community.

2017 Minister s Seniors Service Awards Alice Modin Nomination Form Salutation: Mr. Ms. Mrs. Other Nominee: Home Address: The personal information collected on this form is collected under s. 33(c) of the FOIP Act and will only be used and disclosed to determine the Nominee s suitability and eligibility to receive the Minister s Seniors Service Award and for other reasonably related administrative purposes in accordance with the FOIP Act. If I am selected for an award, I hereby freely consent to the disclosure, as the Ministry deems appropriate, of my name, address, phone number, and any information provided as part of this nomination package, to interested parties including the media for interviews, stories and follow up. I hereby give permission to the Government of Alberta to use my material (photograph, video, name or quotation) without any compensation to me. I understand this material will be used in communication and materials about Government of Alberta programs and services and they will be distributed to the public through a variety of means, including printed and electronic communications. All government communications where this material will appear shall constitute the property of the Government of Alberta, solely and completely. I understand that the material may be used by or licensed to other public bodies and private companies for use in materials in promoting the province of Alberta. I waive all moral rights, claims, and objections arising from the use of this material, worldwide and in perpetuity, in favour of the Government of Alberta, its agents, employees, and contractors. If I have questions regarding my consent or the use of my information, I can contact Communications with Alberta Seniors and Housing by phone at, 780-644-5678, or by mail at 44 Capital Blvd, Third Floor, Edmonton, AB T5J 3S7. Signature Date Nominator Information (The person who would be the best contact to reach for questions about the nominee or the nomination package.) Name: Address: Nomination Deadline: May 19, 2017

Evaluation of Nominations A Nomination Review Committee, selected by the Minister of Seniors and Housing, will review submissions using the following considerations. Nominees do not need to satisfy all considerations to be eligible for an award; instead they are used to guide the Committee to identify individuals and organizations that demonstrate exceptional volunteer service that directly supports seniors. A successful nomination will highlight the following considerations as much as possible. EVALUATION CONSIDERATIONS NEED IMPACT FOCUS DIVERSITY LEADERSHIP ORIGINALITY VOLUNTEER TIME There is a need for the volunteer service provided within the community. The volunteer service provided affects seniors directly and improves the quality of their lives. Volunteer work involves a specialized skill, talent or expertise. The nomination demonstrates a wide variety of volunteer activities. The nominee demonstrates leadership through planning, organizing or initiating a new project or program for the benefit of seniors. The volunteer service provided is unique and demonstrates thoughtfulness of senior s needs. Individuals: The number of volunteer hours is noteworthy. Organization: Number of programs/services/events that involve volunteers. Selection of Recipients The Nomination Review Committee reviews eligibility and recommends a list of award recipients to the Minister of Seniors and Housing. The Minister selects the award recipients. Information about nominees and recipients will be released to the media and posted on www.seniors-housing.alberta.ca. Nominees will be invited to attend community recognition celebrations in the summer. Award recipients will be notified in Summer 2017 and honoured at a special event in the fall. 2016 Minister s Seniors Service Awards recipients with their MLA representatives and Minister Sigurdson

2017 Minister s Seniors Service Awards Checklist Please ensure that your nomination package is complete. The nomination: Demonstrates how the nominee provides volunteer service for the benefit of seniors. Includes a summary of volunteer activities (individual) or summary of key information (organization). Includes letters of support (two to five are advisable). Is legible in English, or has English translation provided. Provides the name and address of nominee. Has been signed by the nominee. Includes contact information for nominator or organization representative. Submissions Forward complete nomination packages to: By mail: Minister s Seniors Service Awards Alberta Seniors and Housing Box 3100 Edmonton, Alberta T5J 4W3 By courier service: Minister s Seniors Service Awards Alberta Seniors and Housing 6th Floor Standard Life Centre 10405 Jasper Avenue Edmonton, Alberta T5J 4R7 Questions? Email your questions to seniorsinformation@gov.ab.ca Deadline To be considered, a complete nomination package must be received by May 19, 2017.