Latornell Leadership Awards Nomination Form

SECTION 1: NOMINEE INFORMATION

Name

First Name

Last Name

Organization

Position/Title

Email

Phone

SECTION 2: NOMINATOR INFORMATION

Name

First Name

Last Name

Organization

Position/Title

Email

Phone

Relationship to Nominee

SECTION 3: NOMINATION DETAILS

Please provide a written nomination (max. 750 words) outlining the nominee’s contributions to environmental conservation in Ontario, specifically addressing: • Leadership and innovation in conservation • Measurable impact of their work • Relevance to award criteria (e.g., policy, research, education, stewardship, climate action) • Length and scope of involvement in the sector.

SECTION 4: SUPPORTING MATERIALS (Optional)

You may attach up to two additional pages of supporting materials (e.g., letters of support, project summaries, articles, awards).

File Upload

Maximum file size: 157.29MB

SECTION 5: NOMINEE CONSENT CONFIRMATION

Please confirm the nominee's awareness of this nomination:

I confirm the nominee is aware of this nomination and consents to be considered for the award.

The nominee has not yet been informed of this nomination but will be contacted before any public announcement.

SECTION 6: DECLARATION

I hereby declare that the information provided in this nomination is accurate to the best of my knowledge.

Signature

Clear

Date