Nomination Form - Canada World Youth

2015
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TRANSFORMATION
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Canada World Youth
is dedicated to enriching the lives of youth
who want to become informed and active global
citizens. CWY offers international transformative
experiences focused on building knowledge,
leadership and skills through participation in
sustainable community-driven projects.
For more than 40 years, 37,000 youth and
12,000 host families have participated in
CWY programs, in Canada and abroad.
www.canadaworldyouth.org
CWY 2015 Youth
Leadership Awards:
Celebrating Youth
Leadership.
Innovation.
Transformation.
Opportunity.
Overview
The CWY 2015 Youth Leadership Awards recognize the outstanding achievements of young Canadians and youth
from around the world who are CWY Alumni and are engaged in innovative initiatives that create change in the
community.
Objectives of the Awards
The main objective of the Youth Leadership Awards is to honour the leadership actions and innovative thinking of
engaged young CWY alumni from Canada and around the world, and one alumnus or alumna aged 35 or older who
has gone on to lead an inspirational life, and truly embodies the spirit of CWY’s mission of being a global citizen.
Through these prestigious Awards, CWY recognizes outstanding young leaders’ involvement in transforming
communities. Their initiatives should have a direct contribution to the achievement of the United Nations Millennium
Development Goals.
Four Categories
• Outstanding Aboriginal Alum Award (up to age 35) - cash award of $3,000
• Guy Bordeleau Outstanding Overseas Youth Alum Award (up to age 35) – cash award $3,000
• Guy Bordeleau Outstanding Canadian Youth Alum Award (up to age 35) – cash award $3,000
• iLead Award to honour an Alumnus/a (age 35+) - cash award $5,000
Eligibility Criteria
To be eligible for the Awards, candidates must:
For the Outstanding Aboriginal Alum Award:
•Be an Aboriginal person who can self-identify as a First Nation, Métis or Inuit; within the meaning of Section 35
(2) of Canada’s Constitution Act, 1982 which defines Aboriginal peoples as Indian (First Nation), Inuit and Métis
peoples of Canada.
• Fulfill all the Outstanding Youth Alum Awards criteria.
For the Guy Bordeleau Outstanding Youth Alum Awards:*
• Be nominated by a third party, no self-nominations are accepted.
• Be 35 years of age or under as of December 31, 2014.
• Be a CWY alumnus or alumna.**
• Have exhibited leadership.
• Have demonstrated a commitment to creating change in a community.
• Have contributed to an initiative with measurable impact in a community.
• Have taken part in an initiative that contributes to the achievement of the United Nations Millennium
Development Goals.
• Be available to take part in the Award Celebration Event in Toronto on June 11, 2015.
• ONLY for Guy Bordeleau Outstanding Canadian Youth Alum Award: Be a Canadian citizen or permanent resident.
For the iLead Award:
• Be nominated by a third party, no self-nominations are accepted.
• Be 35 years of age or older as of December 31, 2014
• Be a Canadian citizen or permanent resident.
• Be a CWY alumnus or alumna**
• Have gone on to lead an inspirational life, and truly embodies the spirit of CWY’s mission of being a global citizen
• Be available to take part in the Award Celebration Event in Toronto on June 11, 2015.
Selection Process
Candidate nominations are reviewed by an independent jury panel composed of leaders from the business
community and civil society, who have demonstrated a commitment to youth education and leadership.
Calendar
Beginning of Nomination Period.................................................................................................................................. March 2015
Nomination Deadline....................................................................................................................................................... May 7, 2015
Selection of Laureates........................................................................................................................................................ May 2015
Award Ceremony, The Fifth Social Club, Toronto, Ontario ..................................................................................June 11, 2015
* Aboriginal Youth are not precluded from the Guy Bordeleau Outstanding Canadian Youth Alum Awards.
** Our definition of Alumni includes someone who has taken part in any of the Canada World Youth programs.
N FORM
NOMINATIO
CWY 2015 Youth
Leadership Awards:
Celebrating Youth
Leadership.
Innovation.
Transformation.
Opportunity.
PART A
Please indicate which category you are submitting this nomination:
Outstanding Aboriginal Alum Award (up to age 35)
Guy Bordeleau Outstanding Overseas Youth Alum Award (up to age 35)
Guy Bordeleau Outstanding Canadian Youth Alum Award (up to age 35)
iLead Award (age 35+)
Information on the Nominee
Last name: .............................................................................................................................................................................................................
First name: .............................................................................................................................................................................................................
Female/Male/Other: ............................................................................................................................................................................................
Street address: .....................................................................................................................................................................................................
City: ..........................................................................................................................................................................................................................
Province/Region: ..................................................................................................................................................................................................
Country: ..................................................................................................................................................................................................................
Postal code: ...........................................................................................................................................................................................................
Date of birth – year/month/day: ......................................................................................................................................................................
Phone number (include all codes): .................................................................................................................................................................
Fax number (include all codes): .......................................................................................................................................................................
PLEASE SUBMIT
ELECTRONICALLY
OR PRINT IN INK.
This form is confidential
when submitted.
E-mail address: .....................................................................................................................................................................................................
Please specify the name, year, host country, and host communities of the CWY program in which you took part:
...................................................................................................................................................................................................................................
...................................................................................................................................................................................................................................
The nominee must be
informed of your intention to
put his or her name forward.
For Aboriginal Nominee, please specify the cultural group, and community or First Nation they are from:
NOMINATION CHECKLIST
• A completed nomination form
...................................................................................................................................................................................................................................
• A copy of the nominee’s
passport (identification page)
• Supporting documents,
such as testimonials,
news clippings,
photographs, etc.
• One letter of support,
from someone other than
the nominator
• A current biography
of the nominee, prepared
by the nominee
(400 words maximum)
...................................................................................................................................................................................................................................
Information on the Nominator
All nominations must be third-party submissions supported by independent documentation. Self-nominations will
not be accepted.
Last name: .............................................................................................................................................................................................................
First name: .............................................................................................................................................................................................................
Street address: .....................................................................................................................................................................................................
City: ..........................................................................................................................................................................................................................
Province/Region: ..................................................................................................................................................................................................
Country: ..................................................................................................................................................................................................................
Postal code: ...........................................................................................................................................................................................................
Phone number (include all codes): .................................................................................................................................................................
Fax number (include all codes): .......................................................................................................................................................................
E-mail address: .....................................................................................................................................................................................................
Relationship to nominee: ....................................................................................................................................................................................
N FORM
NOMINATIO
CWY 2015 Youth
Leadership Awards:
Celebrating Youth
Leadership.
Innovation.
Transformation.
Opportunity.
PART B
Community Initiative that nominee has contributed to
Responses can be attached in another document. For the iLead Award, simply describe in detail why the nominee
has gone on to lead an inspirational life, and truly embodies the spirit of CWY’s mission of being a global citizen.
1. Name of the community initiative:
2. Location (city/country):
3. Year initiative started:
4. Number of months/years that the nominee has been involved in the initiative:
5. Initiative’s target group (describe the community and the number of people impacted by the initiative):
6. Is the initiative or organization registered as a non-for-profit entity?
7. Brief description of initiative’s mission and activities: (100-150 words) (10 points)
8. Describe how the initiative promotes sustainable development at the local or international level and/or
contributes to the achievement of the United Nations Millennium Development Goals: (100-150 words) (10 points)
9. Two references who can attest to the nominee’s credibility, including name, work, position, relationship
with the nominee, telephone number and email address:
Nominee’s Involvement
Please respond to the following questions. Each response should be a maximum of 400 words. Responses can
be attached in another document. Feel free to attach other relevant supporting material – website, annual reports,
published articles, photos, etc.
Submissions will be evaluated
by a panel of judges chaired
by a Board member of
Canada World Youth.
The evaluation will be based
solely on the contents
of the nomination form,
supporting documents,
letter of support and
biography. Submissions
that do not meet the eligibility
requirements will not be
considered.
1. What role is the nominee playing in the community initiative? How did the nominee demonstrate leadership?
(20 points)
2. How would you describe the nominee’s commitment to the initiative? (15 points)
3. Why would you classify this project as being sustainable or contributing to the achievement of the United
Nations Millennium Development Goals? (15 points)
4. How would you describe the impact of the project in the community and the impact of the nominee’s contribution
to the initiative? (20 points)?
Please submit your completed nomination package by May 7, 2015.
To submit your nomination by email, all documents (nomination form and supporting documentation) must be
submitted in ONE email to [email protected] . All documents should carry the same title format: “Nominee’s
name – Nomination form” or “Nominee’s name – Biography”. Any documents submitted separately from the
nomination package will not be considered.
To submit your nomination by post, please send your package to: Selection Committee, Canada World Youth
2015 Leadership Awards, 2330 Notre-Dame West, 3rd floor, Montreal, Quebec CANADA, H3J 1N4. It is the
responsibility of the nominator to ensure that the nomination package is complete and received by Canada World
Youth before the deadline. Please note that nomination packages will not be returned.
Only selected candidates will be contacted.