Required fields are marked with asterisks (*)

Accessibility Champion Nomination Form

The Accessibility Champion Award was created to recognize and celebrate individuals, local businesses, or community groups who have demonstrated a continued passion and commitment to making the community more accessible. Questions marked with an asterisk ( * ) require a response.

Nominee Business Name:

Nominee Full Name

Street Address:

City and Province:

Postal Code:

Phone Number:

Is this the nominee's business or personal phone number?

Business

Personal

Please select reasons for nominating this business or individual as an Accessibility Champion:

Physical Environment: a building, interior, or outdoor space was purposely designed, modified, or renovated to eliminate barriers and enhance access for people with disabilities

Customer Service: the nominee is breaking down barriers that prevent customers with disabilities from accessing the services they need. (Barriers include physical, architectural, technological, information or communication, organizational and attitudinal.)

Employment: the nominee is an employer who is making their workplace practices accessible to potential or current workers with disabilities

Financial Planning: the nominee plans for and dedicates funds for accessibility improvements over time

Culture and Leadership: the nominee leads a culture of accessibility and inclusion consistently and works to exceed minimum standards

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