2025 Community Award Nomination Form / Formulaire de mise en candidature

2025 Community Award Nomination Form / Formulaire de mise en candidature – Prix communautaires 2025

Thank you for nominating someone for a 2025 Cystic Fibrosis Canada Community Award. You can also nominate yourself if you wish. If you need to take a break, you can save your nomination and finish it later by clicking any "Save & Continue Later" button below. Please note that you'll need to sign up to use this feature and will be asked to create a password for privacy reasons. You may be asked to create an updated password that is HIPAA compliant.
Remarque : Pour afficher le formulaire en français, veuillez utiliser le bouton situé dans le coin supérieur droit afin de sélectionner votre langue préférée.
About You - Nominator Information
Your Name (Nominator)*

First NameLast Name
Your Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
Your Phone Number*
Please enter a valid phone number.
Award Criteria

Please review the award criteria carefully. Your nomination will need to provide specific information about the criteria so please be prepared to share specific details and information to submit. You may need to begin the application and save it as you look up specific details. Steps to save your work are at the very beginning of this form.
Here is the 2025 Awards Guidebook with award criteria and general eligibility details to help guide your submission. Please carefully review the criteria before selecting which award you are submitting a nomination for. You can also visit https://cysticfibrosis.ca/community-awards for further information.
Vous trouverez dans ce guide des prix 2025 les critères et les conditions générales d’admissibilité pour vous aider à préparer votre mise en candidature. Nous vous invitons à les lire attentivement afin de choisir le prix le plus approprié. Pour plus de détails, vous pouvez également consulter la page Web https://fibrosekystique.ca/programme-de-prix-communautaires) pour plus d’informations.
Which Award are you submitting a nomination for? See Awards summary above.*

Pamela Summerhayes Award (for those living with CF)Céline AwardMila Mulroney Award (family impacted by CF)Beyond Limits AwardEva Markvoort Award (under 35 yrs old)Mission Catalyst - Financial Contributions AwardMission Catalyst - Voluntary Contributions AwardChange Maker of the Year Award (third-party event for Cystic Fibrosis Canada)

Pamela Summerhayes Award

If you've selected the wrong option, please click on the "back" button at the end of this page to return and make a different selection.
The Pamela Summerhayes Award honours an individual living with cystic fibrosis who has demonstrated exceptional commitment and has had an impact on the cystic fibrosis cause.

Criteria:
- Individual who lives with cystic fibrosis
- Any type of contribution (financial/voluntary)
- The nominee has made an exceptional impact by drawing attention to the cystic fibrosis cause and the work of Cystic Fibrosis Canada. This may be through public speaking, rallying the community at Cystic Fibrosis Canada events or by leading their own event, public awareness or advocacy campaigns, marketing campaigns, making donations or raising funds or a combination.
- This individual demonstrates commitment to Cystic Fibrosis Canada with at least 5 years involvement.
Name of individual being nominated (Nominee). Note: self nominations are accepted. *

First NameLast Name
Email of Nominee*
example@example.com
What province or territory does the nominee live in?*
Does this individual live with Cystic Fibrosis?*

YesNo
Has the nominee been involved with Cystic Fibrosis Canada for at least 5 years?*

YesNoUnsure
Please indicate the years the nominee has been actively involved with Cystic Fibrosis Canada*
ie 2015- present. The years do not have to be sequential
Please describe the nominee's involvement, both financial and/or voluntary with Cystic Fibrosis Canada. Please include as many details (dates, activities) as possible.*
Please describe how the nominee has drawn attention to the cystic fibrosis cause and the work of Cystic Fibrosis Canada (for example public speaking, rallying the community at Cystic Fibrosis Canada events or by leading their own event, public awareness or advocacy campaigns, marketing campaigns, making donations or raising funds or a combination of all these). Share as many details as possible such as names of project, how the nominee was involved and dates.*
Is there anything else specifically related to the award criteria that is important for reviewers to know about this nominee? Note: if nothing, please type "N/A". *
Note: there are further questions on the following page, including an opportunity to upload supporting documents.

Céline Award

If you've selected the wrong option, please click on the "back" button at the end of this page to return and make a different selection.
The Céline Award acknowledges an individual or group who has made significant and sustained contributions of time, talents or expertise to Cystic Fibrosis Canada activities in their local community. They are involved in multiple ways and often seen as wearing “many hats” due to their dedication.

Criteria:
- Individual or group (couple, family or members of a Cystic Fibrosis Canada event or program committee)
- Contributions are of a voluntary nature (see definition list)
- Involvement is varied and across multiple programs or events (research, community engagement, programs, fundraising, events, etc)
- Seen as a significant contributor to the local cystic fibrosis community and specifically Cystic Fibrosis Canada events and programs
Are you nominating an individual or group?*

IndividualGroup
Name of individual being nominated (Nominee). Note: self nominations are accepted. *

First NameLast Name
Email of nominee:*
example@example.com
What is the name of the group you are nominating? *
for example: Carstar - Calgary Store #23, Kin Club of St. John's, etc
Name of person who is the primary contact person for nominee group? *
Email of person who is the primary contact person for nominee group:*
example@example.com
What province or territory does the nominee live in?*
Please describe the nominee's voluntary involvement (including dates) with Cystic Fibrosis Canada. Please include as many details (specific activities, etc) as possible.*
Please list the programs or events (research, community engagement, programs, fundraising, events, etc) the nominee is/was involved in if not noted above.
Please describe what makes the nominee's contributions significant to the local cystic fibrosis community and specifically Cystic Fibrosis Canada events and programs.*
Is there anything else specifically related to the award criteria that is important for reviewers to know about this nominee/group? Note: if nothing, please type "N/A".*
Note: there are further questions on the following page, including an opportunity to upload supporting documents.

Mila Mulroney Award

If you've selected the wrong option, please click on the "back" button at the end of this page to return and make a different selection.
The Mila Mulroney Award honours a family directly impacted by cystic fibrosis that has made ongoing financial contributions to Cystic Fibrosis Canada, through continued fundraising efforts as a family.

Criteria:
- Family directly impacted by cystic fibrosis
- Have continuously raised funds for Cystic Fibrosis Canada through donations, hosting their own fundraisers and/or participating in Cystic Fibrosis Canada led fundraising (Walk, Trek, etc) or a combination of these
- Have been consistently financially contributing to Cystic Fibrosis Canada over a period of 10 years or more
What is the name of the family you are nominating? *
for example: the Franklin family, the Singh-Patel family, etc
Name of person who is the primary contact person for nominee group:*

First NameLast Name
Email of person who is the primary contact person for nominee group:*
example@example.com
Please add other family or group member names and emails. Use the "Add row" button to add as many people as needed.
What province or territory does the nominee live in?*
Is the family directly impacted by Cystic Fibrosis? (meaning a member of their immediate family lives/lived with CF)*

YesNo
Please describe the family's journey with cystic fibrosis:*
Has the family been financially contributing to Cystic Fibrosis Canada for at least 10 years?*

YesNoUnsure
Please indicate the years the nominee has been actively involved with Cystic Fibrosis Canada*
ie 2015- present. The years do not have to be sequential
Please describe the family's financial contributions (donations, hosting their own fundraisers and/or participating in Cystic Fibrosis Canada led fundraising (Walk, Trek, etc) ) or a combination of these. Please add dates, event names, amounts and any other details:*
Is there anything else specifically related to the award criteria that is important for reviewers to know about this family? Note: if nothing, please type "N/A".*
Note: there are further questions on the following page, including an opportunity to upload supporting documents.

Beyond Limits Award

If you've selected the wrong option, please click on the "back" button at the end of this page to return and make a different selection.
The Beyond Limits Award honours exceptional impact on mission that has helped to raise the profile of cystic fibrosis and/or Cystic Fibrosis Canada in a new or unique way that has expanded our reach and grown support for the cause. There is no minimum length of commitment, the focus is on impact made.

Criteria:
- Individual, Family or Group (including a company, corporation)
- Any kind of supporter (voluntary, financial or combination)
- Helped to raise the profile of Cystic Fibrosis as a disease and/or Cystic Fibrosis Canada in a new or unique way that has widened our reach and grown support
- Impact has been exceptional regardless of length of time involved. Recent achievements/contributions make this award timely recognition.
Are you nominating an individual or group?*

IndividualGroup
Name of individual being nominated (Nominee). Note: self nominations are accepted. If you've selected the wrong option, please click on the "back" button at the end of this page to return and make a different selection.*

First NameLast Name
What is the name of the group you are nominating? *
for example: Carstar - Calgary Store #23, Kin Club of St. John's, etc
Name of person who is the primary contact person for nominee group:*
Email of Nominee or Contact Person for nominee group*
example@example.com
What province or territory does the nominee live in?*
Please describe the nominee's financial and/or voluntary contributions (or a combination or both) to Cystic Fibrosis Canada. Please add dates, events, amounts and any other details:*
Please describe how the nominee has helped to raise the profile of cystic fibrosis as a disease and/or Cystic Fibrosis Canada in a new or unique way that has widened our reach and grown support*
Please describe how the nominee has had an exceptional impact, including any recent achievements or contributions that would make this award timely recognition for the nominee.*
Is there anything else specifically related to the award criteria that is important for reviewers to know about this family? Note: if nothing, please type "N/A".*
Note: there are further questions on the following page, including an opportunity to upload supporting documents.

Eva Markvoort Award

If you've selected the wrong option, please click on the "back" button at the end of this page to return and make a different selection.
The Eva Markvoort Award is designed to recognize an individual 35 years or younger who has displayed outstanding leadership with initiatives in support of Cystic Fibrosis Canada. They have inspired others to become involved with the cystic fibrosis cause.

Criteria:
- Individual 35 years of age or younger
- Any kind of contribution (financial/ non-financial)
- Displayed outstanding leadership in leading various initiatives that support Cystic Fibrosis Canada (ie Walk Team Captain, event Chair, lead for lived experience working group, etc)
- Inspired others (people and/or groups) to become involved with Cystic Fibrosis Canada
Name of individual being nominated (Nominee). Note: self nominations are accepted. *

First NameLast Name
Email of Nominee*
example@example.com
What province or territory does the nominee live in?*
Please describe the nominee's financial and/or voluntary contributions (or a combination or both) to Cystic Fibrosis Canada. Please add dates, events, amounts and any other details:*
Please confirm the nominee's age at time of nomination - nominee must be 35 years or younger. If you're unsure, please give your best estimate*
Please provide details of how the nominee has displayed outstanding leadership in leading various initiatives that support Cystic Fibrosis Canada (ie Walk Team Captain, event Chair, lead for lived experience working group, etc)*
Please provide details of how the nominee has inspired others (people and/or groups) to become involved with Cystic Fibrosis Canada*
Is there anything else specifically related to the award criteria that is important for reviewers to know about the nominee? Note: if nothing, please type "N/A".*
Note: there are further questions on the following page, including an opportunity to upload supporting documents.

Mission Catalyst - Financial Contributions Award

If you've selected the wrong option, please click on the "back" button at the end of this page to return and make a different selection.
The Mission Catalyst - Financial Contribution Award honours an individual, group or corporation whose financial contributions have had a transformational impact on the Cystic Fibrosis Canada mission. Recipients have demonstrated deep commitment over a minimum of 2 years to Cystic Fibrosis Canada and have embedded the Cystic Fibrosis Canada mission as a personal or organizational priority.

Criteria:
- Individual, Group or Corporation
- History of financial contributions (see definitions)
- Contributions have had a significant positive financial impact on Cystic Fibrosis Canada's ability to drive its mission forward
- Personal or organizational embedding of Cystic Fibrosis Canada’s mission
- Deep personal or organizational commitment to supporting Cystic Fibrosis Canada
Are you nominating an individual, group or company/corporation?*

IndividualGroupCompany/Corporation
Name of individual being nominated (Nominee). Note: self nominations are accepted. If you've selected the wrong option, please click on the "back" button at the end of this page to return and make a different selection.*

First NameLast Name
What is the name of the group or company/corporation you are nominating? *
for example: Carstar - Calgary Store #23, Kin Club of St. John's, etc
Name of person who is the primary contact person for nominee group: *
Email of Individual nominee or the primary contact person for nominee group:
example@example.com
Please provide details of the nominee's history of financial contributions to Cystic Fibrosis Canada. Please add dates, amounts and any other details:*
Please describe how the nominee's contributions have had a significant positive financial impact on Cystic Fibrosis Canada's ability to drive its mission forward*
How has the nominee embedded Cystic Fibrosis Canada’s mission into their life or group/company?*
Please describe the nominee's deep personal or organizational commitment to supporting Cystic Fibrosis Canada*
Is there anything else specifically related to the award criteria that is important for reviewers to know about the nominee?*
Note: there are further questions on the following page, including an opportunity to upload supporting documents.

Mission Catalyst - Voluntary Contributions Award

If you've selected the wrong option, please click on the "back" button at the end of this page to return and make a different selection.
The Mission Catalyst Award – Voluntary Contribution acknowledges someone who has made significant impact on Cystic Fibrosis Canada’s mission through their voluntary contributions over a minimum of 2 years as a voluntary contributor (for full list see definitions). They have been active contributors to the success of one or more projects/programs/events that has benefited the cystic fibrosis community.

Criteria:
- Individual
- Has been contributing in a voluntary capacity in one or more of the following ways:
  
  o   leader in high impact volunteer roles (for example Walk Chair or Committee member, National Advocacy Network volunteer, Peer Connect volunteer)
  
  o   storyteller who has shared their story or been a speaker at events in support of Cystic Fibrosis Canada
  
  o   shared their lived experience through programs like Elevate, lay reviewer for research proposals
- Significant and positive impact on the mission of Cystic Fibrosis Canada through their voluntary involvement. Going beyond participation, they have actively contributed at a leadership level to projects/events/work success that has benefitted Cystic Fibrosis Canada and the cystic fibrosis community.
- Continuously contributing in significant ways with Cystic Fibrosis Canada for at least 2 years or more
Name of individual being nominated (Nominee). Note: self nominations are accepted. *

First NameLast Name
Email of Nominee*
example@example.com
What province or territory does the nominee live in?*
Has the nominee been contributing to Cystic Fibrosis Canada for at least 2 years?*

YesNoUnsure
Please tick all of the ways the nominee has contributed in a voluntary capacity:

leader in high impact volunteer roles (for example Walk Chair or Committee member, National Advocacy Network volunteer, Peer Connect volunteer)storyteller who has shared their story or been a speaker at events in support of Cystic Fibrosis Canadashared their lived experience through programs like Elevate, lay reviewer for research proposalsother (please describe below)
Other - if "other" selected above, please add details here
Please provide details of the nominee's history of voluntary contributions to Cystic Fibrosis Canada. Please add dates, role(s), responsibilities and any other details:*
Please describe how the nominee has had a significant and positive impact on the mission of Cystic Fibrosis Canada through their voluntary involvement. Include details of how the nominee has gone beyond participation, and how they actively contributed at a leadership level to a projects/events/work success which benefitted Cystic Fibrosis Canada and the cystic fibrosis community.*
Is there anything else specifically related to the award criteria that is important for reviewers to know about this nominee? Note: if nothing, please type "N/A".*
Note: there are further questions on the following page, including an opportunity to upload supporting documents.

Change Maker of the Year Award

If you've selected the wrong option, please click on the "back" button at the end of this page to return and make a different selection.
The Change Maker of the Year Award honours an individual or group who demonstrates an exceptional ability to rally and engage the community in support of Cystic Fibrosis Canada through a Change Maker third-party event. Their event also shows significant creativity and innovation.

Criteria:
- Individual or Group who have led a recognized Change Maker third-party fundraising event in support of Cystic Fibrosis Canada (see definition of Change Maker third- party event) within the past 2 calendar years
- Event shows significant creativity and innovation
- Event has rallied and engaged community members in support of Cystic Fibrosis Canada
Are you nominating an individual, group or company/corporation?*

IndividualGroup or Company/Corporation
Name of individual being nominated (Nominee). Note: self nominations are accepted. If you've selected the wrong option, please click on the "back" button at the end of this page to return and make a different selection.*

First NameLast Name
What is the name of the group you are nominating (if they have a name)? *
for example: Carstar - Calgary Store #23, Kin Club of St. John's, etc
Name of person who is the primary contact person for nominee group:*
Please add group member names and emails. Use the "Add row" button to add as many people as needed.
Name of third-party event:*
Is the third-party event hosted through Cystic Fibrosis Canada's Change Maker site?

YesNo
Please provide the URL (web page) of the third-party event
Please provide details of the third-party event (or if the event has taken place over a period of time, multiple years). Please add date(s), amount(s) raised and other details (number of participants, etc). If the event has happened on multiple years, please click the "Add Row" button" to add more rows and details:*
Please provide details of the third-party event's creativity and innovation:*
Please provide details of how this third-party event (or events) has rallied and engaged community members in support of Cystic Fibrosis Canada*
Is there anything else specifically related to the award criteria that is important for reviewers to know about this nominee? Note: if nothing, please type "N/A".*
Note: there are further questions on the following page, including an opportunity to upload supporting documents.

Final nomination details
Please describe what makes the nominee's contributions to the cystic fibrosis community and/or CF Canada exceptional compared to others. Please give as many details as possible to strengthen your nomination*
Why do you feel it's important to recognize this individual/group/corporation now? *
Feel free to upload a supporting document (e.g. news articles, social media posts that highlight the nominee's contributions or successes)

Cancelof
Is the nominee aware they are being nominated for this award? Should they be selected, we will be asking for their consent to stand as a recipient.*

Yes they are awareNo they are not aware
Before submitting your nomination

Please ensure you have provided as much detail as possible in your submission. Keep in mind that the people reviewing your nomination will not know your nominee and can only review the nomination based on the information you provide. Note: the Awards Review Panel may recommend your nomination be considered for a different award category, where fit exists.
Privacy Statement

Cystic Fibrosis Canada (“CF Canada”) is committed to protecting the privacy and the confidentiality of personal information collected by CF Canada, from CF Canada employees, members, donors, volunteers and other stakeholders. The information you share in this form will be handled in accordance with our privacy policy. For more information about our privacy policy, please visit https://cysticfibrosis.ca/privacy
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2025 Community Award Nomination Form / Formulaire de mise en candidature – Prix communautaires 2025

Remarque : Pour afficher le formulaire en français, veuillez utiliser le bouton situé dans le coin supérieur droit afin de sélectionner votre langue préférée.

About You - Nominator Information

Award Criteria

Pamela Summerhayes Award

Note: there are further questions on the following page, including an opportunity to upload supporting documents.

Céline Award

Note: there are further questions on the following page, including an opportunity to upload supporting documents.

Mila Mulroney Award

Note: there are further questions on the following page, including an opportunity to upload supporting documents.

Beyond Limits Award

Note: there are further questions on the following page, including an opportunity to upload supporting documents.

Eva Markvoort Award

Note: there are further questions on the following page, including an opportunity to upload supporting documents.

Mission Catalyst - Financial Contributions Award

Note: there are further questions on the following page, including an opportunity to upload supporting documents.

Mission Catalyst - Voluntary Contributions Award

Note: there are further questions on the following page, including an opportunity to upload supporting documents.

Change Maker of the Year Award

Note: there are further questions on the following page, including an opportunity to upload supporting documents.

Final nomination details

Before submitting your nomination

Privacy Statement