Please provide the contact information for your Nominee should they be selected for this honour
Region*
East (New Brunswick, Nova Scotia, PEI, Nunavut, Newfoundland & Labrador)Central (Ontario & Quebec)West (British Columbia & Yukon)Prairies (Manitoba, Saskatchewan, Alberta & NWT)Network (National)
Nominee’s Name*
Number of years in broadcast journalism*
Nominee’s Company*
Nominee’s Address*
Nominee’s City*
Nominee’s Province*
AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon
Nominee’s Postal Code*
Nominee’s Phone*
Nominee’s Email*
Please provide a brief outline of why you feel this nominee is deserving of this recognition*
Nominator*
Please provide the contact information for the Nominator.
Nominator’s Station*
Nominator’s Address*
Nominator’s City*
Nominator’s Province*
Nominator’s Postal Code*
Nominator’s Phone*
Nominator’s Email*