Nomination Form
Emerson Douyon Multiculturalism Award Candidate

RTF | PDF

Nominee Information

Last Name :

 

First name :

 

Work address :

 

Province :

 

City :

 

Postal Code :

 

Position - Division :

 

Telephone :

 

E-mail :

 

Cellular :

 

Status :

CSC employee :

 

Within an institution :

 

Member of the public :

 

 

Volunteer :

 

Within the community :

 

Other (specify) :

 


Sponsor Information

Last Name :

 

First name :

 

Work address :

 

Province :

 

City :

 

Postal Code :

 

Position - Division :

 

Telephone :

 

E-mail :

 

Cellular :

 

Status :

Employee Supervisor or Manager :

 

Colleague :

 

Member of the public :

 

 

Volunteer supervisor :

 

Friend :

 

Other (specify) :

 


Justification

Additional pages attached:

Yes

 

No

 

1. The candidate promotes initiatives that support CSC multiculturalism objectives.

 

2. The candidate demonstrates support to the successful reintegration of ethnocultural offenders.

 

3. The candidate facilitates programs such as mentorship, volunteerism, leadership, and civic education among ethnocultural offenders and at-risk ethnocultural youth.

 

4. The candidate promotes inter-cultural understanding and Canadian values (democracy, freedom, human rights and laws that supports our system within CSC), through community initiatives, with the objectives of addressing issues of cultural social exclusion and radicalization.

 

5. The candidate demonstrates effort to bring positive impacts in his/her environment.

 


Approval

Sponsor’s Signature :

Name in script letters :

Signature :

Date :

Candidate’s Manager Signature  ;

Name in script letters :

Signature :

Date :

Candidate’s Director Signature :

Name in script letters :

Signature :

Date :

Assistant Commissioner/Regional Deputy Commissioner Signature (or representative) :

Name in script letters :

Signature :

Date :