2015 Bouchie - Milburn Lake Community Champion AWARDS

Hosted by the Bouchie Lake Country Store

Nomination Form * Deadline for Nominations to be received is September 15, 2015, 4 pm. * Awards will be presented on September 26, 2015 during the Bouchie Lake Harvest Festival * Descriptions of the “Community Champion Categories” are attached to the Nomination Form.

Category of Community Champion (please check one) 1. Community Celebrity (age 18 and under) ___ 2. Communtiy Celebrity (over 19) ___ 3. Volunteer of the Year ___ 4. Community Spirit ___ 5. Paying It Forward Award ___

Nominee’s Contact Information

Your Contact Information

Why are you nominating this person and /or business?Support your nomination – For a nominee to be eligible, all criteria points must be addressed in a detailed description that does not exceed 250 words on a separate sheet of paper. Please give as much detail for the criteria that will showcase your nomination. Documents that support your nomination are of value (e.g. certificates, newspaper clippings, etc.). One form for each category. Incomplete nominations will be disqualified. For a listing of categories and their criteria, please see below.

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Please return your Nomination, by hand or mail, in a sealed envelop to Bouchie Lake Country Store

2338 Bonny Road, Bouchie Lake (Quesnel), V2J 7G6; T: 250.249.0228 / T: blcountrystore@telus.net

Thank you to the following sponsors:Bouchie Lake Country Store, Moose Meadows Farm, Sarah Barber Home Based Esthetician,

Rockys General Store, Hitchin’ Post Cold Beer & Wine Store, Hair by Mare,Moonshine Coffee Roasters, Cariboo Youth Resources, & TL Designs

Nominee’s Name

Address (Mailing)

Telephone Numbers

Email

Your Name

Telephone Numbers

Email

2015 Bouchie - Milburn Lake Community Champion AWARDS

Hosted by the Bouchie Lake Country Store

All nominations will be shared with be kept confidential and be shared with a Nomination Committee who will review the Nominations and make the final decisions.

Community Champion Awards program encourages volunteerism and recognizes outstanding examples of achievement of residents and not for profit organizations within the BL-ML communities.

1. Community Celebrity (age 18 and under): a person who resides in the Bouchie Lake - Milburn Lake communities and is age 18 or under who has been recognized at the National, Provincial, Regional or Local level for an achievement in sport, music, the arts, etc.2. Community Celebrity (age 19 and older): a person who resides in the Bouchie Lake - Milburn Lake communities and is 19 years or older who has been recognized at the National, Provincial, Regional or Local level for an achievement in sport, the arts, music, etc.3. Volunteer of the Year - a person who resides in the Bouchie Lake - Milburn Lake communities who has made a difference by volunteering and their actions have made a positive impact on their community (not necessarily only in Bouchie Lake - Milburn Lake)4. Community Spirit Award - a person or not for profit organization who resides or holds events in the Bouchie Lake - Milburn Lake area and displays community pride by doing things that create a positive environment in the community and obviously cares about the community of Bouchie Lake - Milburn Lake and its residents5. Paying it Forward Award - person, not for profit, and /or business living and /or based in the Bouchie Lake - Milburn Lake area who does things for others without expecting anything in return. These actions simply make our communities a better place to live, work, and play.

Thank you to the following sponsors:Bouchie Lake Country Store, Moose Meadows Farm, Sarah Barber Home Based Esthetician,

Rockys General Store, Hitchin’ Post Cold Beer & Wine Store, Hair by Mare,Moonshine Coffee Roasters, Cariboo Youth Resources, & TL Designs