Recreation Volunteer Recognition Award Response ID:29 Data 1. Welcome to the nomination form for the Recreation Volunteer Recognition Award. These awards are presented by Alberta Culture and Tourism at the ARPA and Energize Conference in October 2016. Before you begin the application, please review the Award Criteria, and the checklist below to ensure you have the necessary information to complete the nomination. Nominee Contact Information A municipal endorsement (either an uploaded document with proof of endorsement or e-mail from office of municipality) A list of the recreation or organization board involvement of the nominee A further description of nominees' recreation contributions The nominee's most significant volunteer contribution to recreation development and why you think this individual is qualified to receive an award. 2. Contact Information 1. Nominee (individual or group being nominated) Title Ms. Jane Smith Mailing Address 123 45 St City/Town Ardrossan Province Postal Code T6T1V3 7805555555
Phone Number (Home) 7809995555 Email Address email@email.com Occupation Retired Number of years nominee has lived in community 30 2. Nominator Title Mr. John Jones Mailing Address 222 55 st City/Town Ardrossan Province Postal Code T6T1V3 7809999988 Phone Number (Home) 7809994444 Contact Person (if additional information is required) email@email.com Phone 7809997777 3. Municipal Endorsement
Municipality Strathcona County Linda Green Position/Title: Councillor 7809993333 Proof of Municipal Endorsement. Please do ONE of the following: 1. Upload a document (short letter, PDF of e-mail, etc.) from the municipal endorser with a one-sentence approval of the nominee OR 2. Have the municipal endorser e-mail their approval of the nominee to Alyssa Watson 3. (untitled) 4. Please list the nominee's Recreation Organization or Board Involvement (do not include non-recreation involvement) 1. Name of Recreation Organization or Board : Ardrossan Soccer Association Executive or Board Position Held : President Number of years : 3 Time Period (specific years) : 2012-2015 To support and promote the sport of soccer in Ardrossan. 2. Name of Recreation Organization or Board : Ardrossan Recreation Association Executive or Board Position Held : Vice president Number of years : 6 Time Period (specific years) : 2006-2012 To support, advocate and fund raise for recreation activities, programs and facilities in the community. 3. Name of Recreation Organization or Board : Ardrossan and Area Seniors Club Executive or Board Position Held : Board member Number of years : 10
Time Period (specific years) : 2005-2015 To provide education opportunities and recreation programs for seniors to promote healthy active lifestyles and wellbeing. Would you like to add more? 4. (untitled) 5. What recreation events, programs, services, facilities and/or policies has the nominee contributed to? Please describe and include whether the volunteer's role involved creating new initiatives or enhancing existing ones. Jane played an active role in fundraising to have the community centre built and was a vital part of the project management team that oversaw the design of the facility. She ensured that the space would be usable for all types of recreation programs for all ages. Because this new facility was now accessible for wheelchair users, Jane created a new adapted fitness program for participants with physical impairments. In her time with the Ardrossan Recreation Association she helped start a program that teaches new Canadians about camping. Enrollment in this program grows every year. In her time with the local soccer association she was instrumental in growing the annual tournament to double its size. The increased registration for the tournament helped grow revenue for the association. With the extra revenue Jane recommended the board purchase additional soccer and other sports equipment to be available to anyone in the community to rent for free. 6. Describe the nominee's most significant volunteer contribution to recreation development and why you think this individual is qualified to receive an award. List any recreation involvement that has not already been included elsewhere in the form. Jane has been a significant contribution to recreation advancement in our community. Her biggest contribution has been her drive and commitment to making recreation accessible to everyone in the community. She saw that there was a need in our community to provide recreation opportunities to both people with physical challenges and those who couldn't afford regular programs. Her vision, passion and leadership paved the way for our residents to live healthy, active and social lifestyles. Jane has spent countless hours ensuring that everyone gets a chance to participate in a recreation activity they are interested in. She has worked tirelessly to ensure barrier-free access and participation in recreation for everyone in our community. Her leadership has inspired others to give back to the community and continue to keep programs and events running. REMINDER: Did you attach a file with your municipal endorsement? If not, please remember to have the municipal endorser e-mail a one-sentence approval of the nominee to Alyssa Watson. 5. Thank You! Thank you for your nomination! The awards committee looks forward to reviewing your application. Response ID: 29 Survey Submitted: Jun 14, 2016 6:20 PM IP Address: 142.229.93.156
Language: English (en-us,en;q=0.8) User Agent: Mozilla/5.0 (Windows NT 6.1; Win64; x64) AppleWebKit/537.36 (KHTML, like Gecko) Chrome/51.0.2704.63 Safari/537.36 Http Referrer: http://www.surveygizmo.com/s3/2740436/energize-award Page Path: 1 : (SKU: 5) 3 : (untitled) (SKU: 6) 3 : (untitled) (SKU: 6) 4 : (untitled) (SKU: 7) 5 : Thank You! (SKU: 2) SessionID: 1465831137_575ecee1742de4.89210418 Response Location Country: Canada Region: City: Edmonton Postal Code: T6K Long & Lat: Lat: 53.460899353027, Long:-113.45189666748