Dialogue Award Nomination Form

I wish to submit the following nomination for the Lieutenant-Governor's Dialogue Award.

Please provide a concise, up-to-date statement of why you feel this nominee meets the Award's objectives: service, core values, leadership, creativity, and contribution to the community or province. Nominations can be substantiated by testimonials, by including the title of produced and published works, by including a resume and references, or by any other pertinent information. Please send supporting documents to dialogue@nbnet.nb.ca.

Optional information You may wish to provide the names of two individuals who are familiar with the nominee's achievements and who would be willing to offer further information on this candidate.

Please provide the name and contact information of the person who presented this nomination and forward everything to dialogue@nbnet.nb.ca by June 30, 2017.

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