proudly presents
New Pioneers Awards
"Celebration of Diversity"
On-line Nominee Form
for Arts Award
sponsored by
Complete this form only if you have been nominated.
Information about you, the Nominee:
Name:
Mailing Address:
City:
Postal Code:
Telephone (work):
Telephone (home):
Email address
Age
(at which you arrived in Canada)
Age
(current)
18 - 29
30 - 45
46 - 59
60+
Languages spoken
Arts discipline
Portfolio
All portfolios must be submitted by September 24, 2010.
Electronic
Click
here
to submit your portfolio electronically.
Hard Copy
Please mail, or drop off, your portfolio to:
Skills for Change
791 St. Clair Avenue West
Toronto, Ontario M6C 1B7
Information about your Nominator:
Name:
Mailing Address:
City:
Postal Code:
Telephone (work):
Telephone (home):
Email address
You are being nominated for which category?
Which Category?
Arts
Community Service
Entrepreneurship
Science & Technology
Skills for Change Graduate
Youth
BARRIERS
Please list any difficulties that you had to
overcome in the process of settling in Canada:
ACHIEVEMENTS
Describe your achievements in the
category for which you have been nominated including any
recognitions and awards that you have received.
You will be
asked to verify this information:
COMMUNITY INVOLVEMENT
Describe any other activities that demonstrate your
involvement in your community and the specific role:
