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Local Municipal Champion Nomination Form

Description

Recognizing the great work done in advancing excellence in human services integration and service system management by teams from CMSMs and DSSABs across the province. Teams may include CMSM and DSSAB staff in partnership with community organizations and/or initiatives where CMSM and DSSAB staff work together with their communities.

More About the Local Municipal Champion Award

Nomination Deadline

September 12, 2025

"*" indicates required fields

Nominator Information

Nominators are asked to complete several questions before providing their nominee's information. OMSSA will contact nominators with any clarifying questions and once the Awards Committee has made their selections.
Name*
Date*
Do you have sign-off from your Commissioner / Lead?*
(Nominators must receive sign-off from their Commissioner/Lead)
(please type name)

Nominee Information

(Nominees Main Contact)
(Nominees Main Contact)
(Nominees Main Contact)
Areas of Focus*
Select all that apply
If selected, would you be interested in presenting your project/initiative at next year's OMSSA Exchange Conference?

Commitment to Human Services

*Please review eligibility criteria on our website and limit each response to 300 words or less
(this could include photos of your work, published report, video, etc.)
Drop files here or
Max. file size: 10 GB.
    This field is for validation purposes and should be left unchanged.