2017 Senior of the Year Nomination Form

The Program Guidelines provide details regarding the criteria for this award.

 

Part A – Nomination Criteria

Nominees must meet all of the following criteria:

  •  65 years of age or older
  •  A current resident of Milton for a minimum of one year
  •  Have made contributions to better the Milton Community
  •  Not previously a recipient of the award

Consideration is given based on the following additional criteria:

  •  Past and current contribution to the community after the age of 55
  •  Impact of their involvement
  •  Leadership roles
  •  Community commitment and support

 

Part B – Nominee Contact Information

Part C – Submitted by:

Part D – Voluntary community service in Milton from the age of 55:

Voluntary community service

Part E - Signature/Agreement

Submission deadline: Thursday, February 9, 2017 by 4:30 p.m.

Part F - Supporting Documents

Please include three (3) letters of reference supporting the nomination.

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Community Services Department Address: 150 Mary Street, Milton, ON, L9T 6Z5 For more information, contact Denise Black, Phone: 905-878-7252, ext. 2539, Fax: 905-864-3222 Email: denise.black@milton.ca

Information provided by the applicant and contained within the application form and any applicable attachments, is collected under the authority of the Municipal Act, 2001, Section 11, and will be used to assess Senior of the Year eligibility for the Town of Milton, Community Services Department. If you have questions about this collection, please contact the Recreation Services Analyst, 150 Mary Street, Milton, ON L9T 6Z5, 905-878-7252, ext. 2539.

Select "Continue" [below] to submit your nomination.