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Campbell River’s 2010 Canada Day Celebrations
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Nominate a deserving person to receive a Certificate of Acknowledgement at the Seniors Honour Roll Alumni
Tea sponsored by Quality Foods on Canada Day, July 1, 2010.
Qualifications: ? 60 yrs of age or over ? Not a previous Seniors Honour Roll Alumni recipient ?
Significant volunteer contribution to Campbell River in any of the following areas:
Adult or Youth Programs Children’s or Seniors Programs Family Programs
Arts & Culture Clubs & Associations Community Health
Schools Emergency Services Worship Centres
Governments Transportation Services Labour Unions
Environment Training & Skills other (specify)
Would you like to see a friend, neighbour, relative or associate recognized for generous contribution
of time and service that helps to make our community a great place to live? Please complete this form:
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Nominee’s Name (please print): |
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Nominee’s Address: |
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Nominee’s Phone Number: |
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Nomination Submitted by (please print): |
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Nominator’s Address: |
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Nominator’s Phone Number: |
On a separate sheet, please provide a brief description of the Nominee’s achievements and contributions
in the category selected.
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Submit by June 15, 2010 to:

470 Island Highway, (PO Box 70, Station A), Campbell River, BC, V9W 4Z9
Info 287-3101 Fax: 286-0109