Senior of the Year Award Nominations

The Ontario Senior of the Year Award gives each municipality in Ontario the opportunity to honour one outstanding local Ontarian who after the age of 65 has enriched the social, cultural or civic life of his or her community.

Seniors who qualify for this award may have contributed to many different fields such as the arts, literature, community service, volunteering, education, environment, fitness, and humanitarian activities.

Fill out the form below or download the printable PDF form.

Nomination Criteria

Nominees must:

Be 65 years of age or older
A current resident of the Township of Puslinch
Not currently be holding political office
Be an individual (you cannot nominate couples, groups or yourself)
Give permission to be nominated and agree to submission information

Name of Nominee *

First

Last

Address of Nominee *

Address Line 1

Address Line 2

City

Province

Postal Code

Age of Nominee *

Phone of Nominee *

Email of Nominee

Nominated By: *

First

Last

Address *

Address Line 1

Address Line 2

City

Province

Postal Code

Phone *

Email *

Please tell us about the organizations or individuals your nominee supports, including role and length of service *

Describe how volunteer contributions made by your nominee have benefited an individual, group or the greater community *

Describe how your nominee has acted as a role model or inspiration for others *

(Optional) Please attach not more than two (2) letters of support from indivuduals, organizations or peers highlighting the nominee's contributions

Click or drag a file to this area to upload.

Declaration of Accuracy *

Clear Signature

I have read the nomination rules, regulations and criteria and certify that they accurately describe my nominee’s volunteer work. I agree that the nominee is a resident of the Township of Puslinch, is at least 65 years of age, is aware of this nomination and the submission information being provided.

Freedom of Information Disclaimer
Personal information on this form is collected under the authority of the Municipal Freedom of Information and Protection of Privacy Act and is maintained in accordance with the Municipal Freedom of Information and Protection of Privacy Act. Questions regarding the collection of this information may be directed to the Township Clerk’s office.