Status of Women Council of the NWT
Status of Women Council of the NWT

2018 Wise Women Awards

Nomination Form

You can answer these questions by filling out and submitting the information in the form below.

If you require assistance filling out this form, would prefer to give an oral nomination or submit via fax please visit the contact page where you can reach us toll free or via fax. 

Candidates who have won a wise women award in the past, hold public office (i.e. MLA, Chief, etc.) or are deceased are ineligible.

Please use one form per woman nominated.

PART 1: It is important to provide contact information for your nominee.

Who would you like to nominate?

Full Name of Nominee *

PART 1: It is important to provide contact information for your nominee.

Who would you like to nominate?

Full Name of Nominee
Address *
Address
Phone Number *
Phone Number

PART 4: Please mark ALL that apply

*

PART 5:

Each candidate MUST be nominated by two NWT residents. Both names must be included in order for the nomination to stand. Forms with only one name will not be accepted. Please provide contact information for both nominators. Nominees should not currently be in Leadership roles such as Members of the Legislative Assembly or be Chairpersons, Chiefs, and Mayors or be Council Members. The selection committee may need to contact you for more information.

Nominator #1 *

PART 5:

Each candidate MUST be nominated by two NWT residents. Both names must be included in order for the nomination to stand. Forms with only one name will not be accepted. Please provide contact information for both nominators. Nominees should not currently be in Leadership roles such as Members of the Legislative Assembly or be Chairpersons, Chiefs, and Mayors or be Council Members. The selection committee may need to contact you for more information.

Nominator #1
Phone *
Phone
Address *
Address
Nominator #2 *
Nominator #2
Phone *
Phone
Address *
Address