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Peace Medal Nomination

Nomination Categories

Youth (19 and Under)
Individual Youth Youth Group 

Adults (20 and up)
Individual Adult Adult Group 

Permission

In order for this nomination to be considered by the selection committee, the nominee must give permission for her/his/their name to be put forward. Please indicate that such permission has been received: (required)
 Yes No

Nominee Information

Nominee Name (required)

or
Organization Name

Address

City

Province

Postal Code

Home Phone (required)

Work Phone (required)

Email (required)

Person making nomination

Name

Organization Name

Address

City

Province

Postal Code

Home Phone (required)

Work Phone

Email (required)

Please complete all nominee questions

Please attach letter of recommendation and relevant materials, articles or photos that you feel will strengthen your nomination as a zipped file. You can also include your response to the nomination questions instead of responding below.

1. Describe how this person/group is seeking innovative solutions to violence, conflict, discrimination and/or promoting social justice and community cohesion. Describe the work performed. Please be specific.

2. What were the individual's/group's roles and responsibilities in performing the above? Be specific.(required)

3. Describe how this initiative creates a long-term, sustainable impact on individuals or the community. Be as specific as possible, e.g. number of people involved; amount of time; list outcomes; funds raised. (required)

4. Highlight any challenges or obstacles the nominee faced and how they overcame these challenges. (required)

5. Is the nominee paid for their peacemaking work? (required)

6. Has this person/group received any other awards for their work? Please list. (required)

For youth only.

7. Show evidence that the nominee has served as an example to other youth in the pursuit of peace and a non-violent community. (required)

How did you hear about the YMCA Peace Medal?
Newspaper School Flyer YMCA Website Community Group Previous award winner Previous event attendee