WFH International Volunteer Awards
Nomination Form

Please complete and submit the electronic form below to nominate a candidate for a WFH International Volunteer Award.

This form is also available in PDF format. Print and send the completed form to the WFH by:
E-mail: awards@wfh.org
Fax: 514-875-8916
Mail: 1425 René-Lévesque Blvd. West, Suite 1010
Montréal, QC H3G 1T7

The deadline for nominations is March 16, 2012.

International Frank Schnabel Volunteer Award

International Healthcare Volunteer Award

NOMINATOR INFORMATION

This is information about you, the nominator, so we can contact you with any questions.

Email Address*:
Salutation:
First name*:
Last name*:
Title*:

Address*:
City*:
State/Province*:
Country*:
Zip/Postal Code*:
Telephone number (with country, city,
area codes)*:
Fax number (with country, city, area codes):


NOMINEE INFORMATION

Please provide as much detail as possible.  We will contact the nominee should we require additional information.

The name of the sponsor will be kept confidential.

Awards will be presented at the WFH Congress in Paris in July 2012. Do you know if this person will be attending Congress? If not, when would be an ideal time to present an award?

Does this person know that he/she is being nominated?

Yes
No
Salutation:
First name*:
Last name*:
Title*:

Address*:
City*:
State/Province*:
Country*:
Zip/Postal Code*:

Nominated for (check one only):

International Frank Schnabel Volunteer Award
International Healthcare Volunteer Award

In the area below, please provide as much information as possible about the candidate, including biographical information and background, and explaining why the nominee deserves this award. This information should outline his/her significant volunteer commitment, dedication and service to persons with hemophilia or other bleeding disorders, and how he/she has furthered the mission and goals of the WFH, thus meeting the criteria of the particular award. If you would like to send additional documentation about the candidate, email it to awards@wfh.org.

Thank you for your nomination.

*Required fields

 

 

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