Community Achievement Award

Two awards will be presented to persons whose selfless dedication, contribution or philanthropy has positively impacted the Croatian-Canadian community.

Please complete the form below in order to nominate a candidate for this award. In addition, please submit any supporting information and documentation that you may have available to you (i.e. candidate's current curriculum vitae, letter(s) of reference, newspaper clippings, copies of other awards and/or recognitions received, and any other material which may be useful for the Selection Committee in their evaluation of the candidate(s)).

Please feel free to submit as many nominees as you would like. All nominations must be submitted in writing. Verbal nominations will not be accepted. Nominations may be made by on-line submission, regular mail, e-mail, fax or hand delivery. The Chamber will not be responsible for any nominations undelivered by Canada Post, private carriers, or malfunction/misdelivery of electronic data. It is the responsibility of the individual submitting the nomination to ensure that the nomination is received.

By Mail or Hand Delivery:
Anita Vukovic Madzarevic
630 The East Mall
Etobicoke, ON
M9B 4B1

By Fax:
Attn: Anita Vukovic Madzarevic
416.641.2700

By Email:
amadzarevic@croat.ca

All nominations must be received by the nomination deadline, which is April 1, 2012. Late applications will not be accepted.
 



Nominee Information

First Name

Last Name

Date of Birth

Place of Birth

Work Phone

Home Phone

Email

Business Name

Address

Suite #

City

Province

Postal Code



Nomination Criteria

Years in business

How many years have you been aware of this nominee?

Provide a summary of your nominee's contributions and the various
roles your nominee has been involved with in the community



Nominator Contact Information

First Name

Last Name

Phone

Email