Form: Outstanding Achievement Under 40 Years of Age

OUTSTANDING ACHIEVEMENT UNDER 40 YEARS OF AGE

Your Name (required)

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State/Province (required)

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Country

YOUR NOMINEE'S INFORMATION

Full Name (required)

Telephone (required)

Email (required)

Address (required)

City (required)

State/Province (required)

Postal/Zip (required)

Country

Occupation or Profession (required)

Birth Date - must be 40 years of age or under as of June 30th, 2016 *

Month

Day

Year

NOMINEE'S ACCOMPLISHMENT

1. Describe the professional background or other accomplishments that distinguish the nominee as a leader in his or her field of endeavour. *

2. Describe the exemplary contribution of the nominee to the community and explain how the nominee’s achievements and attributes distinguish him or her as a leader in the community. *

3. Describe how the nominee’s contribution has impacted the lives of others, improved the social fabric of our society, or advanced the ideals of Hellenism. *

4. If the nominee is a Philhellene, describe the nominee’s “Greek” connection (for example, describe any relationship to the HHF or Greek community and/or advancement of projects that benefit the Greek-Canadian community or Hellenic ideals).

SUPPORTING DOCUMENTS

Please attach documents, if possible, supporting the accomplishments of the nominee, such as a professional biography of the nominee, news article(s) or publications noting the nominee`s professional or community achievements, list of awards, citations or recognitions.

Supporting document 1

Supporting document 2

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