Champion of Human Services Nomination Form

Description

Recognizing a champion outside of OMSSA who has displayed extraordinary leadership and made an exceptional contribution to human services.

More About the Champion of Human Services 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*

First Last

Email*

Phone*

Organization Name*

Position/Title*

Date*

Do you have sign-off from your Commissioner / Lead?*

(Nominators must receive sign-off from their Commissioner/Lead)

Yes

Please confirm your Commissioner / Lead*

(please type name)

Nominee Information

Name of Nominee*

Nominee's Organization*

Position/Title*

Email*

Phone*

Achievement in Human Services

*Please review eligibility criteria on our website and limit each response to 300 words or less

Please describe the nominee’s track record of achievement in human services*

Please describe how the nominee has been recognized as a thought leader in human services and any provincial and/or nationally significant work*

Please upload a headshot image of the nominee*

Accepted file types: jpeg, jpg, png, Max. file size: 3 MB.

Please upload any additional documents to support your nomination

(this could include a resume, published report, video, etc.)

Drop files here or

Max. file size: 10 GB.

Phone

This field is for validation purposes and should be left unchanged.