OMSSA Awards - Patti Moore HSI Nomination Form

OMSSA Awards - Patti Moore Human Services Integration Nomination Form
Nomination Deadline: September 20, 2024

Description:
Recognizing an OMSSA member or delegate who has displayed extraordinary leadership and made an exceptional contribution to human services.

Criteria:

A proven and respected track record of achievement in human services and in the development and/or application of the theory and practice of human services integration.
Demonstrated experience and commitment in placing clients/people at the centre of the planning and administration of human services.
Someone who has strengthened or broadened internal and external relationships to achieve a common vision of seamless service delivery.

Nominations Process:

Any OMSSA member can nominate another individual, including themselves.
Only one nomination per member will be accepted.
Nominators must receive sign-off from their Commissioner/Lead.
The total number of award recipients is limited to one (1) person per year; however, exceptions will be made for more than one deserving recipient.
As part of your application, we kindly ask that you include a headshot photo and supporting documentation and/or video (up to 2 minutes) demonstrating the nominee’s work.

Equity, Diversity, and Inclusion
OMSSA encourages nominations that reflect the diversity of our membership, in particular from individuals from racialized groups and Indigenous Peoples to ensure that our awards are reflective of the racial diversity of the populations our members serve.

Nominator Information
Nominators are asked to complete several questions before providing their nominee's information. OMSSA will contact nominators with any clarifying questions and once the Awards Committee has made their selections.

First Name *

Last Name *

Email *

Organization Name *

Date: *

Position/Title: *

Phone Number: *

Do you have sign-off from your Commissioner / Lead? (Nominators must receive sign-off from their Commissioner/Lead) *

Yes

Please confirm your Commissioner / Lead (please type name): *

Nominee Information

Name of Nominee: *

(Nominee Main Contact): Position/Title: *

(Nominee Main Contact): Email Address: *

(Nominee Main Contact): Phone Number: *

Nominee's Organization: *

COMMITMENT TO HUMAN SERVICES INTEGRATION

*Please review eligibility criteria on our website and limit each response to 300 words or less

Please describe how the nominee’s work has contributed to a track record of achievement in human services and in the development and/or application of the theory and practice of human services integration: *

(Word limit: 300)

Please describe the nominee’s commitment in placing clients/people at the centre of the planning and administration of human services: *

(Word limit: 300)

Please provide examples of the nominee’s ability to strengthen and/or broaden internal and external relationships to achieve a common vision of seamless service delivery: *

(Word limit: 300)

Please upload a headshot image of the nominee (please limit upload to 3MB, must be in .jpeg/.jpg or .png format): *

Please upload any additional documents to support your nomination (this could include a resume, published report, video, etc.)

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