Community Service Awards Nomination Form

THE COMMUNITY SERVICE AWARDS NOMINATIONS ARE OPEN AUGUST 31 - OCTOBER 4, 2026

Nominator

Please provide your contact information for our Community Service Awards Task Force should they require more information on your nomination.

Nominee

This nomination is for the following category:
Is the nominee a resident of Pitt Meadows? In the case of a business, operating from a Pitt Meadows location?
* In order to be eligible for this award, the nominee must be a resident of Pitt Meadows and in the case of a business, must be operating out of a Pitt Meadows location in accordance with the Terms of Reference.
If you are nominating an individual, have you received their consent?
*Consent is not required for Business Nominations.
I confirm I am not an immediate family member of the nominee
* Nominations by immediate family members and self nominations will not be accepted in accordance with the Terms of Reference.

Selection Criteria

Please describe how the nominee has demonstrated outstanding contributions and achievements in the following award criteria areas:
Please provide a response of at least 250 characters (approximately 40–45 words).
Unlimited number of files can be uploaded to this field.
64 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.
Please provide a response of at least 250 characters (approximately 40–45 words).
Please provide a response of at least 250 characters (approximately 40–45 words).
If we feel the nominee may be a better fit under a different category, are you ok if we move them into it?
How did you hear about the Community Service Award nominations?

NOTICE: By submitting this nomination form, you are confirming that the person you are nominating has authorized you to provide their information as disclosed on this form.

Your personal information is being collected pursuant to section 126.c of the Freedom of Information & Protection of Privacy Act. This information will be used to administer the Community Service Awards Program. Any questions regarding the collection, use, disclosure or safeguarding of your personal information included on this form can be forwarded to: Privacy Head, 604.465.5454, clerks@pittmeadows.ca.

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