Courage Award Application

Nominee(*)

Please enter the name of the person you wish to nominate

Nominee Telephone(*)

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Nominee Email(*)

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Nominee Address

Nominator name(*)

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Nominator Contact Number(*)

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Nominator Email(*)

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Nominator Address

Why are you nominating this person?(*)

Please describe examples of how the nominee has demonstrated personal courage and how these actions have impact others as well as themselves

About the Nominee(*)

Tell us about the nominee and how they would benefit from 2 weeks at Camp Emerson

Additional Information

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Courage Award Nomination Form