Awards Nomination Form

The CIC Executive Committee keeps all nominations confidential to respect privacy and to avoid disappointment if the nominee is not selected. We ask that nominators and others involved respect this policy.

Select the award for which the nominee is being nominated.

NOMINEE

*NAME

*ADDRESS

*CITY

*PROVINCE/TERRITORY

*POSTAL CODE

*TELEPHONE (work)

TELEPHONE (home/mobile)

*E-MAIL

Download form including your responses to PDF Excel