Nominee Information Name Address Email Phone Group/Business Affiliations The above is being nominated for (choose one): Community Volunteer Award Citizen of the Year Award Innovation Award Business of the Year Award Environment Award Agriculture/Agri-business Award Description of the contribution Nominator's Information Name Address Email Phone number Please check here if you are willing to assist in the presentation of the award to the recipient, should your nomination be successful: Yes No Consent for storing submitted data * Yes, I give permission to store and process my data No, I don't consent to storing and processing my data Personal information, as defined in the Municipal Freedom of Information and Protection of Privacy Act (MFIPPA), is collected under the authority of the Municipal Act, 2001 and will be used in accordance with MFIPPA. The information will be used to determine recipients of the Erin Community Recognition Awards. Questions about this collection of personal information should be directed to the Clerk's Office, 5684 Trafalgar Road, Hillsburgh, ON N0B 1Z0, Telephone, 519.855.4407 x248 or lisa.campion@erin.ca
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