Nomination Form–Naresh James Award Submissions will be accepted until 4:30 p.m. on Friday, June 14th, 2019. Naresh James Award The Naresh James Champion of Mental Health Award is presented at the Annual General Meeting and recognizes an individual who has championed critical challenges, pioneered initiatives and achieved lasting impact in support of those who live with mental health issues; along with friends and families. This individual has demonstrated commitment to support people who live with mental health challenges through their leadership, advocacy, and perseverance. Criteria: The Nominee promotes grass root initiatives in consideration of the social determinants of health, which have resulted in policies, best practices and services that have improved the mental health of people living in the counties of Haliburton, Kawartha, Pine Ridge. Please see hyperlinked Social Determinants of Health: http://www.thecanadianfacts.org/ Name of Nominee First Last Address of Nominee Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Nominee's Email Address Nominee's Phone NumberHow has the nominee’s work improved the mental health of people living in the counties of Haliburton, Kawartha, Pine Ridge?Please write your response here. Maximum of 500 words.Does this person know you are submitting their name? Yes No Your Name First Last Your Address Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland & LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Your Email Your PhoneHow do you know the nominee? (e.g., family member, friend, colleague, etc)
