Fillable Nomination Form Distinguished Service Award street city province/state (University of Manitoba)

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Nomination Form Distinguished Service Award street city province/state (University of Manitoba)

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NOMINEE INFORMATION
Distinguished Service Award
Nomination Form
Name of Nominee:
Address of Nominee:
street city province/state
country postal code/zip code telephone
email address
Degrees held by the Nominee, including name of the university awarding each degree:
Degree Institution Date
Name of Nominator:
Address of Nominator:
street city province/state
country postal code/zip code telephone
email address
Notice Regarding Collection, Use, and Disclosure of Personal Information by the University
Your personal information is being collected under the authority of The University of Manitoba Act. The information you
provide will be used by the University for the purpose of verifying your eligibility to nominate a candidate, and for
communicating with you regarding this nomination. Information regarding nominations and awards may be made public.
Your personal information will not be used or disclosed for other purposes, unless permitted by The Freedom of
Information and Protection of Privacy Act (FIPPA). If you have any questions about the collection of your personal
information, contact the Access & Privacy Office (tel. 204-474-9462), 233 Elizabeth Dafoe Library, University of
Manitoba, Winnipeg, MB, R3T 2N2.
2
NOMINATIONS MUST BE SUBMITTED NO LATER THAN DECEMBER 31
NOMINATIONS MAY BE SUBMITTED BY CLICKING ON THE “SUBMIT” BUTTON BELOW
OR
BY SENDING TO:
Distinguished Service Award Committee
c/o Office of the University Secretary
The University of Manitoba
312 Administration Building
Winnipeg, MB R3T 2N2
INQUIRIES SHOULD BE DIRECTED TO:
Ms. Shelley Foster
Associate University Secretary (Board of Governors)
Telephone: 204-474-6165
Email: shelley.foster@umanitoba.ca
Nominations submitted without the following documents will be returned to the Nominator:
A letter from the Nominator describing reasons for nominating the Nominee, including a short description
of the actions or special accomplishments that constitute distinguished contributions to Manitoba in areas
which are of major interest to the University of Manitoba and/or which are directly associated with the
University.
Nominee’s abridged curriculum vitae containing details such as education, field of endeavour, a short
description of publications, if any, specials awards, and distinguished service.
A short biographical summary of the nominee (maximum 150 words).
(Please see page 3 of this document for more information.)
(NOTE: Clicking the "SUBMIT" button should create a draft email with this Nomination Form automatically attached.
Please be sure to attach all necessary documentation before sending the email. If the button does not work, please
send materials to shelley.foster@umanitoba.ca or to the above address.)
SUBMIT
3
Distinguished Service Award
Information
Purpose
Distinguished Service Awards are awarded to individuals, groups, and organizations whose contributions
improve the social or cultural well-being of the people of Manitoba. The Award is intended to recognize those
whose service efforts build a better province for us all. The focus of the Award is the recognition of distinguished
community service to the University, the City of Winnipeg, and the Province of Manitoba, as opposed to individual
achievements.
Eligibility
All residents of Manitoba, who are not current employees of the University of Manitoba, are eligible for nomination
for the Distinguished Service Award.
Normally, no more than two Distinguished Service Awards shall be awarded in one academic year.
Process
The Distinguished Service Award Committee meets annually to review nominations.
Nominations approved by the Committee are recommended to the Board of Governors.
Elections for Distinguished Service Awards are held at a meeting of the Board of Governors. Voting is by secret
ballot, and election results are confidential.
A reserve list of approved candidates for the Award is maintained by the Board of Governors.
Documents
The documents prepared and submitted by the nominator are to indicate the significance of the candidate’s
accomplishments, to state very briefly why a candidate should be elected, and to establish that the candidate
has achieved such distinction as described in the Distinguished Service Award Policy.
Those preparing the biographical summary are asked to respect the limitation of length of 150 words.
The documents should be as readable as possible while sufficiently detailed in content to allow those considering
the nominations to make a confident assessment of the candidate’s achievements for voting purposes. When a
candidate is selected by the Distinguished Service Award Committee, these documents may be the only
materials that will be circulated to the Board of Governors to help them in their voting. If a nominee is approved,
the information contained in the documents may be used to inform and assist in the preparation of an official
citation for all related publications.
Additional information respecting the Distinguished Service Award can be found at:
http://umanitoba.ca/admin/governance/governing_documents/community/267.html
The list of individuals who have received Distinguished Service Awards can be found at:
http://umanitoba.ca/admin/governance/distinguished_service_award.html
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Nomination Form Distinguished Service Award street city provincestate (University of Manitoba)

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Completed 20 October 2020

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