Nomination Form- Achievement Through Adversity - CMHA Haliburton, Kawartha, Pine Ridge

Achievement Through Adversity Award

The Achievement through Adversity Award is presented at the Annual General Meeting, honouring an individual who has shown continued courage and tenacity in reaching their goals. In education, employment, volunteering or through the tasks of daily living, the recipient of the Achievement through Adversity Award is a role model for others on their journey to a healthy life. Criteria: Nominees must be an individual with lived experience of mental illness who currently is, or has previously, received services from C.M.H.A. H.K.P.R.

Name of Nominee
First Last
Address of Nominee
Street Address Address Line 2 City Province Postal Code
Nominee's Email Address
Nominee's Phone Number
What has this person achieved through adversity in education, employment, volunteering and/or through tasks of daily living?
Please write your response here. Maximum of 500 words.
The nominee is an individual with lived experience of mental illness who currently is, or has previously, received services from C.M.H.A. H.K.P.R.*
- Yes
Does this person know you are submitting their name?
- Yes
- No
Your Name
First Last
Your Address
Street Address Address Line 2 City Province Postal Code
Your Email
Your Phone
How do you know the nominee? (e.g., family member, friend, colleague, etc)
CAPTCHA

Nomination Form– Achievement Through Adversity

Submissions will be accepted until 4:30 p.m. on Monday, June 21st, 2024.

Achievement Through Adversity Award