Distinction Awards nomination form

Please send your completed nomination form to your regional office

Distinction Awards
(PDF, 72 KB)

The nominee (individual or Harbour Authority) – contact information

First name

Last name

Harbour Authority

Nomination category:

Individual Achievement Distinction Award

Harbour Authority Achievement Distinction Award

Harbour Authority Innovation Distinction Award

Long Standing Service Distinction Award

Up and Comer Distinction Award

City/Town:

Province:

Postal code:

Telephone (day):

Fax:

Email:

The individual or Harbour Authority nominated – contact information

First name

Last name

Harbour Authority

City/Town:

Province:

Postal code:

Telephone (day):

Fax:

Email:

The nominee – achievement information

Describe the nominee’s current involvement with their Harbour Authority and clearly indicate how the nominee has met each of the criteria listed for their category of nomination. Please use additional pages as required.

*As per Personal Information Bank Harbour Authority Recognition Program - DFO PPU 275, personal information is collected under the authority of the Fishing and Recreational Harbours Act for the purpose of the Harbour Authority Recognition Program. It may be used for determine eligibility for the award and to allow the selection committee to assess the nomination and disclosed to the selection committee and senior management for approvals. Failure to provide this information may result in your nomination not being considered. You have the right to the correction of, access to, and protection of your personal information under the Privacy Act and to file a complaint with the Privacy Commissioner of Canada over DFO’s handling of your information.

Date modified:: 2025-08-26

Language selection

Search

Distinction Awards nomination form

The nominee (individual or Harbour Authority) – contact information

The individual or Harbour Authority nominated – contact information

The nominee – achievement information