The Loraine Anderton Award of Excellence in Health Services

This award recognizes outstanding mentors who are pursuing and contributing to the dynamic fields within health services.

Nominee Information (information about the individual being nominated)

First Name

Last Name

Nominee's Email Address

Street Address

City

Province

Country

Postal Code

Phone Number

Work Phone

Ext.

Preferred method of contact

Main Phone

Work Phone

E-mail

Organization/Company

Health Organization

Mentor Nomination Support Commentary (must be completed by the nominator)

Describe how the mentor demonstrates being a Guide and a Teacher? Provide examples to support your application.

Explain how the mentor Supervised and provided feedback to help youth interns develop their skills. Provide examples to support your application.

Describe how the mentor was a Safety Advisor for youth interns. Provide examples to support your application.

Tell us why you think the Nominee deserves to be recognized. Provide examples to support your application.

Please include a photo of the Nominee: (OPTIONAL)

Please include any additional documents (Word or PDF) to support your nomination here: (OPTIONAL)