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Accessibility Achievement Award Nomination Form

Please complete the following form to Nominate an Individual, Organization, School or Business for the Tillsonburg Accessibility Achievement Award.

Nominations can be submitted at any time throughout the year.


The Nominee must be one of the following (Please check one)
Please select the Type of Nomination being submitted.
Please select the Award Category(s) to which your Nomination applies.

Allowed extensions pdf, doc, docx, xls, xlsx, jpg, jpeg, gif, png, tif


Personal Information contained on this form is collected pursuant to Section (29) of the Municipal Freedom of Information and Protection of Privacy Act, R.S.O. 1990 and will be used for the purposes of determining the recipient(s) of the Accessibility Achievement Award.

Questions regarding this collection should be directed to the Clerk's Office at 519-688-3009 Ext. 4041.

Please check declaration box.

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