Community Award Form 2012
2012Wembley Community Award
Name of Nominee: __________________________________________
Mailing Address: ___________________________________________
Phone Number: ____________________________________________
Nominating Organization: ___________________________________
Main Volunteer activities with this organization: ______________
____________________________________________________________
Volunteer activities with other organizations: _________________
____________________________________________________________
In 250 words or less please explain why you feel this person deserves the 2012Wembley Community Award (please attach)
Submitted by:
Name: _____________________________________________________
Mailing Address: ___________________________________________
Phone Number: ____________________________________________
Signature: _________________________________________________
Deadline for nomination: Thursday, April 4th, 2013 by 2:00 pm
Applications will be accepted: Town Office, 9940 - 101 St, Wembley, AB
FAX: 780-766-2868 or email: office@wembley.ca