Name of Nominee**

Role/position (Check one):

Person being nominated (Check one):

Name of Individual or Group as it should appear on Inspire Award Certificate


School(or HDSB/community affiliation):


Phone or Email of Nominee


Name of Nominator**

School (or HDSB/community affiliation):

Position/Relationship to nominee:

Email AND Phone Number is required!

Email


Phone


Signature



Briefly describe in the space provided why this person(s) is deserving of this recognition, particularly how they have gone above and beyond to: demonstrate caring, initiative, innovation, creativity, inspire others, support students and contribute to their achievement.


PLEASE ENSURE SPELLING IS CORRECT AS RECIPIENTS' NAMES WILL BE PRESENTED AS THEY APPEAR ON THIS FORM.
*Note: Superintendents, the Director of Education, Associate Director and publicly elected trustees cannot be nominated for an Inspire Award.


Please do not submit the form multiple times. You will receive an acknowledgement email shortly to confirm the submission has been successfully received.
Submit the completed
Nomination Form online		Hard copy Nomination Forms
may be sent to:
Director's Office, JW Singleton Centre,
PO Box 5005, STN LCD 1, Burlington,ON
L7R 3Z2 Fax 905-335-4447
Attention: Inspire Awards