College of Fellows Nomination

Fellows are elected to the Society’s College of Fellows and are entitled to attend and vote at any Annual General Meeting of the College. According to the Operating Bylaw of the Society, Fellows “are expected to promote the objectives and interests of the Society.” Thus, nomination and election to the College is intended to secure active support for the Society and is not solely a means to honour individuals.

The Fellows Committee invites nominations of worthy candidates with appropriate backgrounds who are willing and able to serve the Society. Completed nominations must be received by Saturday, August 31, 2013 to be considered. 

Please fill in the form below as completely as possible. Fields marked with an asterisk are required.

Nominator Information
Please fill in your contact information below in case we need to contact you regarding this nomination.
Salutation	Mr Mrs Miss Ms Dr
* Your First Name:
* Your Last Name:
Your Organization: (if applicable)
* Street Address:
Street Address (continued):
* City:
* Province:	Alberta British Columbia Manitoba New Brunswick Newfoundland & Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon
Postal Code:
Telephone:
* E-mail:

Candidate’s Information
This is a nomination for …
Salutation	Mr Mrs Miss Ms Dr
* First Name:
* Last Name:
* Professional affiliation:
Contact Details:
Work Home
Organization: Required if “Work” selected above
* Street address:
Street address (continued):
* City:
* Province:	Alberta British Columbia Manitoba New Brunswick Newfoundland & Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon
Postal code:
Telephone:
* E-mail:
* Service to Society: How has the nominee assisted the Society to date?
* Community Leadership: How would the nominee’s community leadership assist the Society in making Canada better known?
Other Considerations:

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