Patti Moore HSI Nomination Form

Description

Recognizing an OMSSA member or delegate who has displayed extraordinary leadership and made an exceptional contribution to human services.

More About the Patti Moore HSI 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*

Commitment to Human Services Integration

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

Please describe how the nominee’s work has contributed to a track record of achievement in human services and in the development and/or application of the theory and practice of human services integration*

Please describe the nominee’s commitment in placing clients/people at the centre of the planning and administration of human services*

Please provide examples of the nominee’s ability to strengthen and/or broaden internal and external relationships to achieve a common vision of seamless service delivery*

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.