Canadian Cancer Society Division Awards Leadership

Canadian Cancer Society Division Awards Leadership Inspirational Achievement in Volunteer Youth Leadership Award The Inspirational Achievement in Volunteer Youth Leadership Award is offered annually to a Canadian Cancer Society youth volunteer who has made a significant divisional contribution to the fight against cancer within the leadership domain. Characteristics A successful nominee is a Canadian Cancer Society volunteer who: is a role model who inspires and helps peers to better understand and appreciate volunteering made a sustained and innovative contribution to the Canadian Cancer Society demonstrates leadership, initiative, perseverance and originality consistently demonstrates commitment and dedication specific to their involvement with the Society engages and motivates others toward a common vision or action embodies the values of the Society: caring, courage, integrity, progressive Criteria A successful nominee is a Canadian Cancer Society volunteer who: is under 25 years of age has coached, inspired and mentored peers went above and beyond the requirements to volunteer has previously received recognition at the community level (where applicable) meets characteristics as listed above Nomination process Nominations are accepted from division volunteers or staff. Number of awards granted will be determined by each division. Electronic submissions are encouraged as well as video submissions. If submitting a video, please provide video in the following formats:.mov,.avi or.wmv. Private YouTube submissions are welcomed as well. The video must be private through YouTube, and a link must be provided. If submitting a video or DVD, please answer all of the questions in Part B in the video and complete and submit Part A of the nomination form. (Check with your division for the best method of submission.) Nominations will be reviewed by a divisional review panel. Inspirational Achievement in Volunteer Youth Leadership 1

Division Awards Nomination Form: Inspirational Achievement in Volunteer Youth Leadership Part A. Nominee and nominator information 1. Please provide the contact information of the nominee Date of nomination submission: City: Postal code: Province/Territory: Daytime phone number (with area code): Extension (if applicable): Email address: Preferred language of nominee: English French Previous awards: Please ensure the information provided is accurate, including proper spelling of the nominee s name, title and details that support why this individual should be recognized. 2. Confirm the eligibility of the nominee This nominee is under 25 years of age This nominee has been endorsed by the district representative 3. Please provide your contact information City: Postal code: Province/Territory: Daytime phone number (with area code): Extension (if applicable): Email address: Inspirational Achievement in Volunteer Youth Leadership 2

Part B. Nominee impact Please review the characteristics included in the award description and address them in your response to the following questions. You may complete this section of the nomination form on separate paper in writing or submission of a video. In your description be sure to include the nominee s full name, which award they are being nominated for and specific examples as to why the nominee deserves to be recognized. Please limit your description to a maximum of one page (approximately 250 words). Describe significant achievements that illustrate the nominee s outstanding leadership skills while volunteering for the Society. In what ways has the nominee made an impact within their community, region or division on behalf of the Society? How has the nominee coached, inspired or mentored peers? In what ways has the nominee gone above and beyond any academic requirements to volunteer? Other appropriate information about the nominee that relates to the award (include feedback from others). Information contained in this nomination is private and confidential. Best efforts should be exercised to protect and maintain total confidentiality. This form should be securely stored and made accessible only to those involved in the nomination process. Thank you On behalf of the Canadian Cancer Society [XX] Division, thank you for your submission. Completing the nomination process clearly shows your commitment to strengthen volunteerism, and your recognition of Society volunteers helps improve the well- being of the Society and its supporters. Inspirational Achievement in Volunteer Youth Leadership 3

Canadian Cancer Society Division Awards Leadership Achievement in Volunteer Leadership - Jim Connors Award The Achievement in Volunteer Leadership Award is offered annually to the Canadian Cancer Society volunteer or group of volunteers that has exhibited exemplary leadership and made a significant contribution that has helped further the mission of the Society. Nominees demonstrate energy and vision in their field of endeavour, going beyond expectations. Characteristics A successful nominee is a Canadian Cancer Society volunteer or group that: shows energy, vision and exceptional commitment in their field of endeavour has made an outstanding contribution to advance the work of the Society serves as a positive role model by: o being innovative o being solution- oriented and striving for excellence o demonstrating collaboration and teamwork o inspiring, engaging and motivating others toward a common vision or action embodies the values of the Society: caring, courage, integrity, progressive Criteria A successful nominee is a Canadian Cancer Society volunteer or group that: has demonstrated divisional, regional or community impact has previously received recognition at the community level (where applicable) meets characteristics as listed above Nomination process Nominations are accepted from division volunteers and staff. Number of awards granted will be determined by each division. Electronic submissions are encouraged as well as video submissions. If submitting a video, please provide video in the following formats:.mov,.avi or.wmv. Private YouTube submissions are welcomed as well. The video must be private through YouTube, and a link must be provided. If submitting a video or DVD, please answer all of the questions in Part B in the video and complete and submit Part A of the nomination form. (Check with your division for the best method of submission.) Nominations will be reviewed by a divisional review panel. Achievement in Volunteer Leadership 1

Division Awards Nomination Form: Achievement in Volunteer Leadership Part A. Nominee and nominator information 1. Please provide the contact information of the nominee or a representative (if a group nomination) Date of nomination submission: City: Postal code: Province/Territory: Daytime phone number (with area code): Extension (if applicable): Email address: Preferred language of nominee: English French Previous awards: Please ensure the information provided is accurate, including proper spelling of the nominee s name, title and details that support why this individual or group should be recognized. 2. Confirm the eligibility of the nominee This nominee has been endorsed by the district representative 3. Please provide your contact information City : Postal code: Province/Territory: Daytime telephone number (area code): Extension (if applicable): Email address: Achievement in Volunteer Leadership 2

Part B. Nominee impact Please review the characteristics included in the award description and address them in your response to the following questions. You may complete this section of the nomination form on separate paper in writing or submission of a video. In your description be sure to include the nominee s full name, which award they are being nominated for and specific examples as to why the nominee deserves to be recognized. Please limit your description to a maximum of one page (approximately 250 words). Describe significant achievements that illustrate the nominee s outstanding leadership skills while volunteering for the Society. In what ways has the nominee made an impact within their community, region or division on behalf of the Society? Describe how the nominee has inspired, engaged and motivated others towards a common vision or action. Other appropriate information about the nominee that relates to the award (include feedback from others). Information contained in this nomination is private and confidential. Best efforts should be exercised to protect and maintain total confidentiality. This form should be securely stored and made accessible only to those involved in the nomination process. Thank you On behalf of the Canadian Cancer Society Division, thank you for your submission. Completing the nomination process clearly shows your commitment to strengthen volunteerism and your recognition of Society volunteers help improve the well- being of the Society and its supporters. Achievement in Volunteer Leadership 3

Canadian Cancer Society Division Awards Leadership Award of Courage The Award of Courage is offered annually to a Canadian Cancer Society volunteer who has furthered the mission of the Society while demonstrating exceptional courage in their personal battle with cancer. In doing so, the individual serves as an inspiration and role model to others. Characteristics A successful nominee is a Canadian Cancer Society volunteer who: engages and inspires others toward a common vision or action is highly regarded for their personal commitment to and unwavering support of the Society has been a source of inspiration to others through their personal actions, bringing a greater awareness and education about cancer has an impact on others through their personal stories embodies the values of the Society: caring, courage, integrity, progressive Criteria A successful nominee is a Canadian Cancer Society volunteer who: has experienced cancer personally inspired others with their courage and selfless commitment during or after their cancer journey has significantly helped to further the mission of the Society has previously received recognition (e.g. Relay For Life Honorary Survivor, International Hero of Hope nominee or recipient) meets characteristics as listed above Nomination process Nominations are accepted from division volunteers or staff. Number of awards granted will be determined by each division. Electronic submissions are encouraged as well as video submissions. If submitting a video, please provide video in the following formats:.mov,.avi or.wmv. Private YouTube submissions are welcomed as well. The video must be private through YouTube, and a link must be provided. If submitting a video or DVD, please answer all of the questions in Part B in the video and complete and submit Part A of the nomination form. (Check with your division for the best method of submission.) Nominations will be reviewed by a divisional review panel. Award of Courage 1

Division Awards Nomination Form: Award of Courage Part A. Nominee and nominator information: 1. Please provide the contact information of the nominee Date of nomination submission: City : Postal code: Province/Territory: Daytime phone number (with area code): Extension (if applicable): Email address: Preferred language of nominee: English French Previous awards: Please ensure the information provided is accurate, including proper spelling of the nominee s name, title and details that support why this individual should be recognized. 2. Confirm the eligibility of the nominee This nominee has been endorsed by the district representative 3. Please provide your contact information City : Postal code: Province/Territory: Daytime telephone number (area code): Extension (if applicable): Email address: Award of Courage 2

Part B. Nominee impact Please review the characteristics included in the award description and address them in your response to the following questions. You may complete this section of the nomination form in writing or submission of a video. In your description be sure to include the nominee s full name, which award they are being nominated for and specific examples as to why the nominee deserves to be recognized. Please limit your description to a maximum of one page (approximately 250 words). Outline the nominee s experience with cancer. Explain how the nominee has inspired others during or after their cancer journey. In what way has the nominee s contribution been national, divisional or district in scope? Other appropriate information about the nominee that relates to the award (include feedback from others). Information contained in this nomination is private and confidential. Best efforts should be exercised to protect and maintain total confidentiality. This form should be securely stored and made accessible only to those involved in the nomination process. Thank you On behalf of the Canadian Cancer Society Division, thank you for your submission. Completing the nomination process clearly shows your commitment to strengthen volunteerism and your recognition of Society volunteers help improve the well- being of the Society and its supporters. Award of Courage 3

Canadian Cancer Society Division Awards Leadership Caregiver Award The Caregiver Award is offered annually to a Canadian Cancer Society volunteer who has furthered the mission of the Society while demonstrating exceptional support to a spouse, partner, family member or friend in their battle with cancer. In doing so, the individual is an inspiration and role model to others. Characteristics A successful nominee is a Canadian Cancer Society volunteer who: engages and inspires others toward a common vision or action is highly regarded for their unwavering support and personal commitment to the Society has an impact on others through their personal stories has been a source of inspiration to others through their personal actions, bringing a greater awareness and understanding of cancer embodies the values of the Society: caring, courage, integrity, progressive Criteria A successful nominee is a Canadian Cancer Society volunteer who: inspires others with their courage and selfless commitment as a caregiver has significantly helped to further the mission of the Society has previously received recognition at the community level (where applicable) meets characteristics as listed above Nomination process Nominations are accepted from division volunteers or staff. Number of awards granted will be determined by each division. Electronic submissions are encouraged as well as video submissions. If submitting a video, please provide video in the following formats:.mov,.avi or.wmv. Private YouTube submissions are welcomed as well. The video must be private through YouTube, and a link must be provided. If submitting a video or DVD, please answer all of the questions in Part B in the video and complete and submit Part A of the nomination form. (Check with your division for the best method of submission.) Nominations will be reviewed by a divisional review panel. Caregiver Award 1

Division Awards Nomination Form: Caregiver Award Part A. Nominee and nominator information 1. Please provide the contact information of the nominee Date of nomination submission: City: Postal code: Province/Territory: Daytime phone number (with area code): Extension (if applicable): Email address: Preferred language of nominee: English French Previous awards: Please ensure the information provided is accurate, including proper spelling of the nominee s name, title and details that support why this individual should be recognized. 2. Confirm the eligibility of the nominee This nominee has been endorsed by the district representative 3. Please provide your contact information City: Postal code: Province/Territory: Daytime phone number (with area code): Extension (if applicable): Email address: Caregiver Award 2

Part B. Nominee impact Please review the characteristics included in the award description and address them in your response to the following questions. You may complete this section of the nomination form on separate paper in writing or submission of a video. In your description be sure to include the nominee s full name, which award they are being nominated for and specific examples as to why the nominee deserves to be recognized. Please limit your description to a maximum of one page (approximately 250 words). Outline the nominee s experience as a caregiver. Describe how the nominee has inspired others with their courage and selfless commitment as a caregiver. Describe how the nominee s personal commitment has significantly helped to further the mission of the Society. Other appropriate information about the nominee that relates to the award (include feedback from others). Information contained in this nomination is private and confidential. Best efforts should be exercised to protect and maintain total confidentiality. This form should be securely stored and made accessible only to those involved in the nomination process. Thank you On behalf of the Canadian Cancer Society Division, thank you for your submission. Completing the nomination process clearly shows your commitment to strengthen volunteerism and your recognition of Society volunteers help improve the well- being of the Society and its supporters. Caregiver Award 3

Canadian Cancer Society Division Awards Leadership Distinction in Volunteer Leadership Award The Distinction in Volunteer Leadership Award is offered annually to a Canadian Cancer Society volunteer who is visionary, innovative and committed, and who mentors leadership in others. The nominee s exceptional contributions and selfless leadership have significantly furthered the mission of the Society. Characteristics A successful nominee is a Canadian Cancer Society volunteer who: is creative and original in their approach to work acts as a role model and mentor to encourage, nurture and train others to become leaders is able to engage and motivate others toward a common vision or action because the nominee: o has energy and vision o demonstrates excellence in volunteer performance o is an effective positive communicator and ambassador of the work of the Society o is a trusted, solution- oriented leader who is able to delegate and allows others to lead o values and is receptive to other opinions and ways of thinking embodies the values of the Society: caring, courage, integrity, progressive Criteria A successful nominee is a Canadian Cancer Society volunteer who: has made exceptional contributions and given selfless leadership that has significantly furthered the mission of the Society has demonstrated national or divisional impact has previously been awarded the Achievement in Volunteer Leadership Award meets characteristics as listed above Nomination process Nominations are accepted from division volunteers or staff. Number of awards granted will be determined by each division. Electronic submissions are encouraged as well as video submissions. If submitting a video, please provide video in the following formats:.mov,.avi or.wmv. Private YouTube submissions are welcomed as well. The video must be private through YouTube, and a link must be provided. If submitting a video or DVD, please answer all of the questions in Part B in the video and complete and submit Part A of the nomination form. (Check with your division for the best method of submission.) Nominations will be reviewed by a divisional review panel. Distinction in Volunteer Leadership 1

Division Awards Nomination Form: Distinction in Volunteer Leadership Part A. Nominee and nominator information 1. Please provide the contact information of the nominee Date of nomination submission: City : Postal code: Province/Territory: Daytime phone number (with area code): Extension (if applicable): Email address: Preferred language of nominee: English French Previous awards: Please ensure the information provided is accurate, including proper spelling of the nominee s name, title and details that support why this individual should be recognized. 2. Confirm the eligibility of the nominee This nominee has been endorsed by the district representative 3. Please provide your contact information City : Postal code: Province/Territory: Daytime phone number (with area code): Extension (if applicable): Email address: Distinction in Volunteer Leadership 2

Part B. Nominee impact Please review the characteristics included in the award description and address them in your response. You may complete this section of the nomination form on separate sheets of paper using your computer s word processing software, by writing by hand or submission of a video. In your description be sure to include the nominee s full name, which award they are being nominated for and specific examples as to why the nominee deserves to be recognized. Please limit your description to a maximum of one page (approximately 250 words). List the leadership positions the nominee has held at the Society during their tenure, and describe significant achievements that illustrate the nominee s outstanding leadership skills. In what ways has the nominee made an impact at the national or divisional level of the Society? Describe how the nominee has inspired, engaged and motivated others towards a common vision or action. Other appropriate information about the nominee that relates to the award (include feedback from others). Information contained in this nomination is private and confidential. Best efforts should be exercised to protect and maintain total confidentiality. This form should be securely stored and made accessible only to those involved in the nomination process. Thank you On behalf of the Canadian Cancer Society [XX] Division, thank you for your submission. Completing the nomination process clearly shows your commitment to strengthen volunteerism and your recognition of Society volunteers help improve the well- being of the Society and its supporters. Distinction in Volunteer Leadership 3

Canadian Cancer Society Division Awards Program Delivery Distinction in Prevention Award The Distinction in Prevention Award is offered annually to a Canadian Cancer Society volunteer or group that has made a significant division contribution to the fight against cancer within the Program Delivery domain. Characteristics A successful nominee is a Canadian Cancer Society volunteer or group that: led to an observable change in health promotion that furthers the mission of the Canadian Cancer Society strives for excellence by enhancing outreach or prevention programs that move the mission forward e.g. a program that helps reduce cancer risk or cancer mortality demonstrates division- wide impact or has the potential to have division- wide impact leads to or initiates key changes that have advanced prevention priorities in the division embodies the values of the Society: caring, courage, integrity, progressive Their action or initiative resulted in a positive impact on 2 or more of the following: public awareness and action regarding healthy living choices supported partnerships with other organizations, if applicable addressed a division- wide priority, for example (to be determined by each division): o early detection and screening o environmental and occupational carcinogen reduction o healthy eating and active living o prevention of youth tobacco use o smoking cessation (increasing the number of people who quit smoking) o UV safety promoting sun safety among children and families and reducing use of tanning beds the goals and mission of the Canadian Cancer Society, leading to lasting, sustainable change Criteria A successful nominee is a Canadian Cancer Society volunteer or group that: includes a combination of volunteers, staff and external organizations or partners has previously received recognition at the community level (where applicable) meets characteristics as listed above Nomination process Nominations are accepted from division volunteers or staff. Number of awards granted will be determined by each division. Electronic submissions are encouraged as well as video submissions. If submitting a video, please provide video in the following formats:.mov,.avi or.wmv. Private YouTube submissions are welcomed as well. The video must be private through YouTube, and a link must be provided. Distinction in Prevention 1

If submitting a video or DVD, please answer all of the questions in Part B in the video and complete and submit Part A of the nomination form. (Check with your division for the best method of submission.) Nominations will be reviewed by a divisional review panel. Distinction in Prevention 2

Division Awards Nomination Form: Distinction in Prevention Part A. Nominee and nominator information 1. Please provide the contact information of the nominee or representative (if a group nomination) Name of group/organization (if applicable): Date of nomination submission: City: Postal code: Province/Territory: Daytime phone number (with area code): Extension (if applicable): Email address: Preferred language of nominee: English French Previous awards: Please ensure the information provided is accurate, including proper spelling of the nominee s name, title and details that support why this individual or group should be recognized. 2. Confirm the eligibility of the nominee This nominee has been endorsed by the district representative 3. Please provide your contact information City : Postal code: Province/Territory: Daytime telephone number (area code): Extension (if applicable): Email address: Distinction in Prevention 3

Part B. Nominee impact Please review the characteristics included in the award description and address them in your response to the following questions. You may complete this section of the nomination form on separate paper in writing or submission of a video. In your description be sure to include the nominee s full name, which award they are being nominated for and specific examples as to why the nominee deserves to be recognized. Please limit your description to a maximum of one page (approximately 250 words). If a group nomination, please list the members of the group and their titles. Describe the action or initiative that the nominee participated in, including its impact. How has the initiative helped advance the mission work of the Society? How has this helped to engage or motivate others? What was the impact of this action? What was the role of the nominee? Other appropriate information about the nominee that relates to the award (include feedback from others). Information contained in this nomination is private and confidential. Best efforts should be exercised to protect and maintain total confidentiality. This form should be securely stored and made accessible only to those involved in the nomination process. Thank you On behalf of the Canadian Cancer Society Division, thank you for your submission. Completing the nomination process clearly shows your commitment to strengthen volunteerism and your recognition of Society volunteers help improve the well- being of the Society and its supporters. Distinction in Prevention 4

Canadian Cancer Society Division Awards Program Delivery Distinction in Support Programs Award The Distinction in Support Programs Award is offered annually to a Canadian Cancer Society volunteer or group that has made a significant division contribution to the fight against cancer in the development or delivery of a program and service. Characteristics A successful nominee is a Canadian Cancer Society volunteer or group that: demonstrates innovation in the delivery of an initiative or program e.g. increases Society presence, extends reach, increases cost effectiveness, improves quality, engages multiple stakeholders strives for excellence by enhancing programs or program delivery that moves the mission forward e.g. a program that positively enhances the quality of life of those living with and beyond cancer engages and motivates others toward a common vision or action leaves a lasting impact that serves as a foundation for future growth and development within the Society embodies the values of the Society: caring, courage, integrity, progressive The program or initiative that the nominee is actively involved in is one that: is division- wide or is notable within the division has the potential to expand within the division or utilize best practices to enhance another community/region/division s programs or initiatives aligns with the direction of the Society s division strategic plan Criteria A successful nominee is a Canadian Cancer Society volunteer or group that: has worked in partnership with the Society includes a combination of volunteers, staff and external partners has previously received recognition at the community level (where applicable) meets characteristics as listed above Nomination process Nominations are accepted from Canadian Cancer Society division volunteers and staff. Number of awards granted will be determined by each division. Electronic submissions are encouraged as well as video submissions. If submitting a video, please provide video in one of the following formats:.mov,.avi or.wmv. Private YouTube submissions are welcomed as well. The video must be private through YouTube, and a link must be provided. Distinction in Support Programs 1

If submitting a video or DVD, please answer all of the questions in Part B in the video and complete and submit Part A of the nomination form. (Check with your division for the best method of submission.) Nominations will be reviewed by a provincial review panel. Distinction in Support Programs 2

Division Awards Nomination Form: Distinction in Support Programs Part A. Nominee and nominator information 1. Please provide the contact information of the nominee/representative (if a group nomination) Name of group/organization (if applicable): Date of nomination submission: City: Postal code: Province/Territory: Daytime phone number (with area code): Extension (if applicable): Email address: Preferred language of nominee: English French Previous awards: Please ensure the information provided is accurate, including proper spelling of the nominee s name, title and details that support why this individual or group should be recognized. 2. Confirm the eligibility of the nominee This nominee has been endorsed by the district representative 3. Please provide your contact information City : Postal code: Province/Territory: Daytime telephone number (area code): Extension (if applicable): Email address: Distinction in Support Programs 3

Part B. Nominee Impact Please review the characteristics included in the award description and address them in your response to the following questions. You may complete this section of the nomination form on separate paper in writing or submission of a video. In your description be sure to include the nominee s full name, which award they are being nominated for and specific examples as to why the nominee deserves to be recognized. Please limit your description to a maximum of one page (approximately 250 words). If a group nomination, please list the members of the group and their titles. Describe the program or initiative. What was the role of the nominee? How has this helped to engage or motivate others? How has the initiative helped advance the mission work of the Society? How has innovation been demonstrated by this nominee? Other appropriate information about the nominee that relates to the award (include feedback from others). Information contained in this nomination is private and confidential. Best efforts should be exercised to protect and maintain total confidentiality. This form should be securely stored and made accessible only to those involved in the nomination process. Thank you On behalf of the Canadian Cancer Society Division, thank you for your submission. Completing the nomination process clearly shows your commitment to strengthen volunteerism and your recognition of Society volunteers help improve the well- being of the Society and its supporters. Distinction in Support Programs 4

Canadian Cancer Society Division Awards Public Policy Distinction in Public Policy Award The Distinction in Public Policy Award is offered annually to a Canadian Cancer Society volunteer or group that has made a significant division contribution to the fight against cancer within the public policy domain. Characteristics A successful nominee is a Canadian Cancer Society volunteer or group that: led to an observable change in public policy that furthers the mission of the Canadian Cancer Society led to or initiated key changes that have advanced cancer control in the division demonstrates division- wide impact or has the potential to have division- wide impact embodies the values of the Society: caring, courage, integrity, progressive Their action or initiative resulted in a positive impact on 2 or more of the following: legislation or regulations government practice or guidelines public policy public policy media attention citizen action Criteria A successful nominee is a Canadian Cancer Society volunteer or group that: has worked in partnership with the Society may include a combination of volunteers, staff and external organizations or partners has previously received recognition at the community level (where applicable) meets characteristics as listed above Note: Any elected politician currently serving in office cannot be nominated. Nomination process Nominations are accepted from division volunteers or staff. Number of awards granted will be determined by each division. Electronic submissions are encouraged as well as video submissions. If submitting a video, please provide video in the following formats:.mov,.avi or.wmv. Private YouTube submissions are welcomed as well. The video must be private through YouTube, and a link must be provided. If submitting a video or DVD, please answer all of the questions in Part B in the video and complete and submit Part A of the nomination form. (Check with your division for the best method of submission.) Nominations will be reviewed by a divisional review panel. Distinction in Public Policy 1

Division Awards Nomination Form: Distinction in Public Policy Part A. Nominee and nominator information 1. Please provide the contact information of the nominee or representative (if a group nomination) Name of group/organization (if applicable): Date of nomination submission: City: Postal code: Province/Territory: Daytime phone number (with area code): Extension (if applicable): Email address: Preferred language of nominee: English French Previous awards: Please ensure the information provided is accurate, including proper spelling of the nominee s name, title and details that support why this individual or group should be recognized. 2. Confirm the eligibility of the nominee This nominee is not an elected politician currently serving in office This nominee has been endorsed by the district representative 3. Please provide your contact information City : Postal code: Province/Territory: Distinction in Public Policy 2

Daytime telephone number (area code): Extension (if applicable): Email address: Part B. Nominee impact Please review the characteristics included in the award description and address them in your response to the following questions. You may complete this section of the nomination form on separate paper in writing or submission of a video. In your description be sure to include the nominee s full name, which award they are being nominated for and specific examples as to why the nominee deserves to be recognized. Please limit your description to a maximum of one page (approximately 250 words). If a group nomination, please list the members of the group and their titles. Describe the action or initiative that the nominee participated in, including its impact. What was the role of the nominee? How did the nominee work in partnership with the Society? Other appropriate information about the nominee that relates to the award (include feedback from others). Information contained in this nomination is private and confidential. Best efforts should be exercised to protect and maintain total confidentiality. This form should be securely stored and made accessible only to those involved in the nomination process. Thank you On behalf of the Canadian Cancer Society Division, thank you for your submission. Completing the nomination process clearly shows your commitment to strengthen volunteerism and your recognition of Society volunteers help improve the well- being of the Society and its supporters. Distinction in Public Policy 3

Canadian Cancer Society Division Awards Revenue Generation Community Champion Award The Community Champion Award recognizes excellence in fundraising by an independent or third- party group in a community that has provided outstanding leadership or financial support (or both) for the Canadian Cancer Society. As a result of this support they have significantly helped further the mission and goals of the Society. Characteristics A successful nominee is a group that: organized an event that is recognized in their community as one that raises funds for the Canadian Cancer Society developed and implemented an event that has been enhanced and can serve as a model for other third- party organizers worked in a spirit of cooperation with Society staff or volunteers embodies the values of the Society: caring, courage, integrity, progressive Criteria A successful nominee is a group who: has sustained success for at least 2 years after implementation contributed to a cumulative value of at least $ (to be determined by the division) has an impact within their community adheres to Canada Revenue Agency rules and regulations has previously received recognition at the community level (where applicable) meets characteristics as listed above Note: Registered Canadian Cancer Society volunteers are not eligible for this award. Nomination process Nominations are accepted from division volunteers and staff. Number of awards granted will be determined by each division. Electronic submissions are encouraged as well as video submissions. If submitting a video, please provide video in the following formats:.mov,.avi or.wmv. Private YouTube submissions are welcomed as well. The video must be private through YouTube, and a link must be provided. If submitting a video or DVD, please answer all of the questions in Part B in the video and complete and submit Part A of the nomination form. (Check with your division for the best method of submission.) Nominations will be reviewed by a divisional review panel. Community Champion Award 1

Division Awards Nomination Form: Community Champion Award Part A. Nominee and nominator information 1. Please provide the contact information of the representative of the group being nominated Name of group/organization: Date of nomination submission: City : Postal code: Province/Territory: Daytime phone number (with area code): Extension (if applicable): Email address: Preferred language of nominee: English French Previous awards: Please ensure the information provided is accurate, including proper spelling of the nominee s name, title and details that support why this individual or group should be recognized. 2. Confirm the eligibility of the nominee This nominee has sustained or exceeded success for at least 2 years after implementation This nominee has been endorsed by the district representative This nominee does not include registered volunteers with the Canadian Cancer Society 3. Please provide your contact information City : Postal code: Province/Territory: Community Champion Award 2

Daytime telephone number (area code): Extension (if applicable): Email address: Part B. Nominee impact Please review the characteristics included in the award description and address them in your response to the following questions. You may complete this section of the nomination form on separate paper in writing or submission of a video. In your description be sure to include the nominee s full name, which award they are being nominated for and specific examples as to why the nominee deserves to be recognized. Please limit your description to a maximum of one page (approximately 250 words). Please list the members of the group and their titles. Describe the event that was organized by the nominee. In what ways has this individual or group provided support for, or engagement with, the Society? How has this helped to engage or motivate others? How has the initiative helped advance the mission work of the Society? Other appropriate information about the nominee that relates to the award (include feedback from others). Information contained in this nomination is private and confidential. Best efforts should be exercised to protect and maintain total confidentiality. This form should be securely stored and made accessible only to those involved in the nomination process. Thank you On behalf of the Canadian Cancer Society Division, thank you for your submission. Completing the nomination process clearly shows your commitment to strengthen volunteerism and your recognition of Society volunteers help improve the well- being of the Society and its supporters. Community Champion Award 3

Canadian Cancer Society Division Awards Revenue Generation Corporate Champion Award The Corporate Champion Award recognizes a corporation, business, employee group or association that has provided outstanding leadership and financial support for the Canadian Cancer Society. It has embraced the Society s mission and has become a valued partner. Characteristics A successful nominee is a corporation, business, employee group or association that: made a significant financial contribution to the division demonstrated a passion for the fight against cancer embodies the values of the Society: caring, courage, integrity, progressive Criteria A successful nominee is corporation, business, employee group or association that: has shown a minimum of 2 years of engagement with the Society with continued demonstration of support engaged with the Society through at least 2 mechanisms of support (such as employee engagement programs, sponsorship, support with marketing, gift in kind) has contributed a minimum value of $ (to be determined by the division) annually adheres to the National Corporate Relationship Gift and Acceptance Policy has previously received recognition at the community level (where applicable) meets characteristics as listed above A corporation is eligible to receive only one Corporate Champion Award during the term of their agreement with the Society. Nomination process Nominations are accepted from division volunteers and staff. Number of awards granted will be determined by each division. Electronic submissions are encouraged as well as video submissions. If submitting a video, please provide video in the following formats:.mov,.avi or.wmv. Private YouTube submissions are welcomed as well. The video must be private through YouTube, and a link must be provided. If submitting a video or DVD, please answer all of the questions in Part B in the video and complete and submit Part A of the nomination form. (Check with your division for the best method of submission.) Nominations will be reviewed by a provincial review panel. Corporate Champion Award 1

Division Awards Nomination Form: Corporate Champion Award Part A. Nominee and nominator information 1. Please provide the contact information of the corporation, business, employee group or association being nominated Name of corporation, business, employee group or association: Date of nomination submission: City: Postal code: Province/Territory: Daytime phone number (with area code): Extension (if applicable): Email address: Preferred language of nominee: English French Previous awards: Please ensure the information provided is accurate, including proper spelling of the nominee s name, title and details that support why this individual or group should be recognized. 2. Confirm the eligibility of the nominee This nominee has a minimum of 2 years of engagement with the Society with continued demonstration of support This nominee has been endorsed by the district representative 3. Please provide your contact information City : Postal code: Province/Territory: Corporate Champion Award 2

Daytime phone number (with area code): Extension (if applicable): Email address: Part B. Nominee impact Please review the characteristics included in the award description and address them in your response to the following questions. You may complete this section of the nomination form on separate paper in writing or submission of a video. In your description be sure to include the nominee s full name, which award they are being nominated for and specific examples as to why the nominee deserves to be recognized. Please limit your description to a maximum of one page (approximately 250 words). In what ways has this nominee provided support for, or engagement with, the Society? Describe the methods of support used by this nominee. How has the nominee embraced the mission of the Society? Other appropriate information about the nominee that relates to the award (include feedback from others). Information contained in this nomination is private and confidential. Best efforts should be exercised to protect and maintain total confidentiality. This form should be securely stored and made accessible only to those involved in the nomination process. Thank you On behalf of the Canadian Cancer Society Division, thank you for your submission. Completing the nomination process clearly shows your commitment to strengthen volunteerism and your recognition of Society volunteers help improve the well- being of the Society and its supporters. Corporate Champion Award 3

Canadian Cancer Society Division Awards Revenue Generation Leadership in Fundraising Relay For Life Award The Leadership in Fundraising Relay For Life Award is offered annually to a Canadian Cancer Society committee of volunteers that has made extraordinary contributions and demonstrated outstanding leadership in overseeing a Relay For Life event within a community. Characteristics A successful nominee is a Canadian Cancer Society volunteer committee that: has significantly advanced Relay For Life and the mission of the Canadian Cancer Society is part of a sustainable event assumes a strong leadership model demonstrates best practices of Relay and focuses on delivering excellence within each of the 5 Development Model Strategies: Leadership, Team, Fundraising, Survivor and Event Operations coaches and mentors others demonstrates the ability to work with others on the development and implementation process of Relay For Life embodies the values of the Society: caring, courage, integrity, progressive Criteria A successful nominee is a Canadian Cancer Society volunteer committee that: has achieved growth in mission engagement (e.g. promotion of the mission to fight cancer, engagement of survivors and caregivers) has showed sustained revenue or growth in revenue each year at their Relay For Life event ensured that all leadership positions on the committee mirror the 5 Development Model Strategies continues to implement a strong succession plan partnered effectively with Society staff to deliver on division strategies has previously received recognition at the community level (where applicable) meets characteristics as listed above Nomination process Nominations are accepted from division volunteers or staff. Number of awards granted will be determined by each division. Electronic submissions are encouraged as well as video submissions. If submitting a video, please provide video in the following formats:.mov,.avi or.wmv. Private YouTube submissions are welcomed as well. The video must be private through YouTube, and a link must be provided. If submitting a video or DVD, please answer all of the questions in Part B in the video and complete and submit Part A of the nomination form. (Check with your division for the best method of submission.) Nominations will be reviewed by a divisional review panel. Leadership in Fundraising Relay for Life 1

Division Awards Nomination Form: Leadership in Fundraising Relay For Life Part A. Nominee and nominator information 1. Please provide the contact information of the Relay For Life committee Name of Relay For Life committee: Date of nomination submission: Title (Dr/Mr/Ms/Miss/Mrs): Chair/Co- chairs first name(s): Chair/Co- chairs last name(s): City: Postal code: Province/Territory: Daytime phone number (with area code): Extension (if applicable): Email address: Preferred language of nominee: English French Previous awards: Please ensure the information provided is accurate, including proper spelling of the nominee s name, title and details that support why this individual or group should be recognized. 2. Confirm the eligibility of the nominee All leadership positions on the committee are filled and mirror the 5 Development Model A succession plan is in place This nominee has been endorsed by the district representative 3. Please provide your contact information City : Postal code: Province/Territory: Daytime telephone number (area code): Extension (if applicable): Email address: Leadership in Fundraising Relay for Life 2

Part B. Nominee impact Please review the characteristics included in the award description and address them in your response to the following questions. You may complete this section of the nomination form on separate paper in writing or submission of a video. In your description be sure to include the nominee s full name, which award they are being nominated for and specific examples as to why the nominee deserves to be recognized. Please limit your description to a maximum of one page (approximately 250 words). List the members of the committee, their titles and their positions. Describe how this committee has advanced Relay For Life and the mission of the Society. Provide concrete examples that demonstrate that the committee s actions have resulted in continued growth in revenue and mission engagement. In what ways has the committee implemented a strong succession plan? Describe the best practices that have been followed or developed as a result of the group s leadership. Other appropriate information about the nominee that relates to the award (include feedback from others). Information contained in this nomination is private and confidential. Best efforts should be exercised to protect and maintain total confidentiality. This form should be securely stored and made accessible only to those involved in the nomination process. Thank you On behalf of the Canadian Cancer Society Division, thank you for your submission. Completing the nomination process clearly shows your commitment to strengthen volunteerism and your recognition of Society volunteers help improve the well- being of the Society and its supporters. Leadership in Fundraising Relay for Life 3

Canadian Cancer Society Division Awards Revenue Generation Relay For Life Team Spirit Award The Relay For Life Team Spirit Award recognizes exceptional contributions to fundraising and mission integration by a team. The team serves as a model for other teams and embodies the spirit of Relay For Life: Celebrate, Remember, Fight Back. Characteristics A successful nominee is a Canadian Cancer Society Relay For Life team that: made a significant financial contribution to the division, with sustained or increased revenue each year acted as ambassadors for Relay For Life and the Society in their community with a spirit of cooperation undertook mission integration in their team fundraising efforts has actively participated during all Relay For Life elements (Survivors Victory Lap, Luminary Ceremony, Fight Back Ceremony) embodies the values of the Society: caring, courage, integrity, progressive Criteria A successful nominee is a Canadian Cancer Society Relay For Life team that: has had an impact within their community, demonstrating passion in the fight against cancer is committed to furthering the goals and mission of the Society has been involved with Relay For Life for a minimum of 2 years has previously received recognition at the community level (where applicable) meets characteristics as listed above Nomination process Nominations are accepted from division volunteers and staff. Number of awards granted will be determined by each division. Electronic submissions are encouraged as well as video submissions. If submitting a video, please provide video in the following formats:.mov,.avi or.wmv. Private YouTube submissions are welcomed as well. The video must be private through YouTube, and a link must be provided. If submitting a video or DVD, please answer all of the questions in Part B in the video and complete and submit Part A of the nomination form. (Check with your division for the best method of submission.) Nominations will be reviewed by a divisional review panel. Relay For Life Team Spirit Award 1

Division Awards Nomination Form: Relay For Life Team Spirit Award Part A. Nominee and nominator information 1. Please provide the contact information of the Relay For Life team and team captain Name of Relay For Life team: Date of nomination submission: Title (Dr/Mr/Ms/Miss/Mrs): Team captain first name: Team captain last name: City : Postal code: Province/Territory: Daytime phone number (with area code): Extension (if applicable): Email address: Preferred language of nominee: English French Previous awards: Please ensure the information provided is accurate, including proper spelling of the nominee s name, title and details that support why this individual or group should be recognized. 2. Confirm the eligibility of the nominee This nominee has been involved in Relay For Life for more than 2 years This nominee has been endorsed by the district representative 3. Please provide your contact information City : Postal code: Province/Territory: Daytime telephone number (area code): Extension (if applicable): Email address: Relay For Life Team Spirit Award 2

Part B. Nominee impact Please review the characteristics included in the award description and address them in your response to the following questions. You may complete this section of the nomination form on separate paper in writing or submission of a video. In your description be sure to include the nominee s full name, which award they are being nominated for and specific examples as to why the nominee deserves to be recognized. Please limit your description to a maximum of one page (approximately 250 words). Please list the members of the team. Describe how this team has integrated the mission of the Society through its fundraising efforts. Show how the team has increased revenue year over year. Describe the team s spirit and participation in the significant elements of Relay For Life. Other appropriate information about the nominee that relates to the award (include feedback from others). Information contained in this nomination is private and confidential. Best efforts should be exercised to protect and maintain total confidentiality. This form should be securely stored and made accessible only to those involved in the nomination process. Thank you On behalf of the Canadian Cancer Society Division, thank you for your submission. Completing the nomination process clearly shows your commitment to strengthen volunteerism and your recognition of Society volunteers help improve the well- being of the Society and its supporters. Relay For Life Team Spirit Award 3

Canadian Cancer Society Division Awards Youth Inspirational Achievement in Youth Vounteer Award The Inspirational Achievement in Volunteer Youth Award is offered annually to a Canadian Cancer Society youth volunteer group or individual who has made a significant divisional contribution to the fight against cancer. Characteristics A successful nominee is a Canadian Cancer Society volunteer who: is a role model who inspires and helps peers to better understand and appreciate volunteering made a sustained and innovative contribution to the Canadian Cancer Society consistently demonstrates commitment and dedication specific to their involvement with the Society embodies the values of the Society: caring, courage, integrity, progressive Criteria A successful nominee is a Canadian Cancer Society volunteer who: is under 25 years of age went above and beyond the requirements to volunteer has previously received recognition at the community level (where applicable) meets characteristics as listed above Nomination process Nominations are accepted from division volunteers or staff. Number of awards granted will be determined by each division. Electronic submissions are encouraged as well as video submissions. If submitting a video, please provide video in the following formats:.mov,.avi or.wmv. Private YouTube submissions are welcomed as well. The video must be private through YouTube, and a link must be provided. If submitting a video or DVD, please answer all of the questions in Part B in the video and complete and submit Part A of the nomination form. (Check with your division for the best method of submission.) Nominations will be reviewed by a divisional review panel. Inspirational Achievement in Youth Volunteer 1

Division Awards Nomination Form: Inspirational Achievement in Youth Volunteer Part A. Nominee and nominator information 1. Please provide the contact information of the nominee or representative (if a group nomination) Date of nomination submission: City: Postal code: Province/Territory: Daytime phone number (with area code): Extension (if applicable): Email address: Preferred language of nominee: English French Previous awards: Please ensure the information provided is accurate, including proper spelling of the nominee s name, title and details that support why this individual should be recognized. 2. Confirm the eligibility of the nominee This nominee is under 25 years of age This nominee has been endorsed by the district representative 3. Please provide your contact information City: Postal code: Province/Territory: Daytime phone number (with area code): Extension (if applicable): Email address: Inspirational Achievement in Youth Volunteer 2

Part B. Nominee impact Please review the characteristics included in the award description and address them in your response to the following questions. You may complete this section of the nomination form on separate paper in writing or submission of a video. In your description be sure to include the nominee s full name, which award they are being nominated for and specific examples as to why the nominee deserves to be recognized. Please limit your description to a maximum of one page (approximately 250 words). If a group nomination, please list the members of the group and their titles. Describe significant achievements that illustrate the nominee s commitment to the Society and our mission. In what ways has the nominee made an impact within their community, region or division on behalf of the Society? How has the nominee inspired their peers? In what ways has the nominee gone above and beyond any academic requirements to volunteer? Other appropriate information about the nominee that relates to the award (include feedback from others). Information contained in this nomination is private and confidential. Best efforts should be exercised to protect and maintain total confidentiality. This form should be securely stored and made accessible only to those involved in the nomination process. Thank you On behalf of the Canadian Cancer Society [XX] Division, thank you for your submission. Completing the nomination process clearly shows your commitment to strengthen volunteerism, and your recognition of Society volunteers helps improve the well-being of the Society and its supporters. Inspirational Achievement in Youth Volunteer 3