Phone Important Details We need to know a few items about you and your nominee. Please use the following fields to provide this information. Your Name * Your Phone Number * Your E-mail * Nominees Name * Nominees Phone Number * Nominees E-mail * Influential How has your nominee demonstrated the ability to inspire their team, organization, peers and community? (Please provide as many examples as possible to support your nomination.) Influence Visionary How has your nominee demonstrated the ability to translate vision to reality and inspire others to be passionate about their goals? Visionary Selfless How has your nominee demonstrated empathy and the ability to put community needs above personal interests? Selfless Accountable How has your nominee ensured that appropriate health and safety systems and procedures are in place to protect people and the public? Accountability Impactful What examples/evidence can you provide of the effectiveness of your nominees impact on the culture of their organization? Impact Innovative How has your nominee demonstrated the ability to influence and inspire their organization and their community? How have they applied innovative thinking to solve problems and new thinking and actions to how they lead, manage and go about their work? Innovation Caring How does your nominee actively care for the well-being of their people and their communities? Care
