2026 EHFC AWARDS NOMINATION FORM

2026 EHFC AWARDS NOMINATION FORM
Prior to completing the form, please review the award criteria on the EHFC website www.ehfc.ca/award-descriptions

Award nominations close June 01, 2026.
Eligibility Criteria:

1) Must hold a Certificate of Public Health Inspection (Canada), CPHI(C)
2) Must be a 2025 Regular or Retired CIPHI Member
3) Must be working in the field of environmental public health or retired within the last five years

Restrictions:

1) One form per nominee, per award is permitted.

If you are nominating more than one person or a team for an award please send an email to EHFCChair@gmail.com in addition to completing this form.

2) An individual can receive any one of the awards only once.

3) No current member of the EHFC Board of Trustees or current member of the CIPHI National Executive Council is eligible for nomination.

Nominator Contact Information:
Nominator Name:*

First NameLast Name
Nominator Email:*
example@example.com
Nominator Phone Number:*
Please enter a valid phone number.Format: (000) 000-0000.
Place of Employment (if applicable):*
Nominator Place of Employment or Personal Mailing Address:*

Street Address

Street Address Line 2

CityProvince

Postal Code

Check the appropriate award you wish to nominate a colleague for:*

T. Duncan Ellison Safe Water Award sponsored by the Canadian Water & Wastewater AssociationClifford E. Van Alstyne Communication Award supported by EHFCDr. R. Neil Lowry Safe Recreational Water Award sponsored by the Lowry GroupLeadership in Environmental Health Award sponsored by Hedgerow SoftwareLilli Ann Zahara Public Health Education Award supported by EHFCFood Safety Award sponsored by NSF
Nominee Information:
Nominee Name:*

First NameLast Name
Nominee Email:*
example@example.com
Nominee Phone:*
Format: (000) 000-0000.
Place of Employment (if applicable):*
Employment or Personal Mailing Address:*

Street Address

Street Address Line 2

CityProvince

Postal Code
Verify that the nominee meets the following eligibility criteria:*

Certificate in Public Health Inspection (Canada) CPHI(C)2025 Member of CIPHIWorking in the field of environmental public health or retired in the past 5 years
Please provide a letter detailing the rationale for the nomination (maximum 500 words). Upload your nomination letter here:*

Note: AI text-generating tools (e.g., ChatGPT, Bing, Notion AI) should not be used to create or falsely embellish any information submitted for an award.
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Provide a brief summary of the nomination in no more than 200 words. If the nominee is selected, the summary will be read aloud at the CIPHI National AEC:*

0/200
Signature*
Date of submission*

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Date
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2026 EHFC AWARDS NOMINATION FORM

Nominator Contact Information:

Nominee Information: