Form Center

2. Name of Nominator*
4. Phone Number of Nominator*
5. Email Address of Nominator*
7. Name of Nominee*
9. Phone Number of Nominee*
10. Email Address of Nominee*
12. Criteria for Arts and Culture*

    To recognize residents for outstanding achievement or contribution in literary, visual, music, performing, or film and video arts, Town of Slave Lake history, or culture. Recipients may be recognized for a single action, or for a contribution or achievement over an extended period. Achievements would be at the highest level available to them. In the selections below please select the category for your nominee.

    1. Literary Arts
    2. Visual Arts
    3. Music
    4. Performing Arts

    1. Film and Video Arts
    2. Town of Slave Lake History
    3. Other
14. Please select all that apply *

    1. Made a significant impact to the Town of Slave Lake
    2. Enhanced to Quality of Life for the Town of Slave Lake
    3. Enhanced the image of the community
    4. Are a professional in their field

    1. Are an amateur in their field
    2. Being recognized for a single action
    3. Being recognized for an achievement over a period of time
16. Please provide further details on why your nominee should be awarded this recognition*
Leave This Blank:


18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

* indicates a required field