ROI - Rural Ontario Institute

Nomination Form: Youth Engagement Showcase

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Your Contact Information

Name:* Relation to Nominee:*

Email:* Phone:*

Nominee Contact Information

First Name:* Last Name:* Email:* Phone: Address:* Town:* Postal Code:*

Age:*

If nominee is under 18 years of age

Parent/Guardian Name: Parent/Guardian Email: Parent/Guardian Phone: Is your nominee and/or their parent/guardian aware of this nomination?* Yes No

About Your Nominee

Using the criteria listed on the Youth Engagement Showcase page (story, impact, programming & organizations) please provide a detailed summary as to why you think your nominee should be featured in the Rural Ontario Institute's Youth Engagement Showcase.

Upload Photo(s)

Please Note: The maximum combined file upload size is 5 MB. If your submission exceeds the size limit, you will need to resize the photos. It may be beneficial to save your written submission as a separate Word document. If you are experiencing issues, please email Tanya at tstuart@ruralontarioinstitute.ca.

All personal information collected is for the sole purpose of establishing consent for participation in this project and for the internal selection of featured stories. Nominees will be contacted prior to any release of information in accordance with Ontario privacy legislation. All nominees have the option to decline participation. For those under the age of 18, signed consent from a parent or legal guardian must be obtained prior to participation.