Annual Civil Courage Award Nomination
Identification of the nominee
Name
*
First Name
Last Name
Occupation
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Connection to British Columbia
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Description of the nominee’s act(s) of civil courage
*
Please tell the story in 500 words or less (about onepage). Be sure to explain how the nominee’s actions exemplify the criteria for civil courage:
Supporting documents
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Supporting documents (for example, articles or personal testimonies) are helpfulbut not required with the nomination letter. If you can provide supporting documents with the letter,please include copies or links to online sources, and submit no more than 3 documents
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Information about you (the nominator)
Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Your relationship to the nominee
Date
*
-
Month
-
Day
Year
Date
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