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Do you know an employer who is a leader in hiring people with disabilities?

How do I nominate an employer for this award?

  1. Complete all five sections of this nomination form with as much detail and examples as possible.
  2. In SECTION 5 - NOMINATION CRITERIA, you need to provide examples.
  3. Eligible employers/nominees are businesses in Surrey-Delta-White Rock.
  4. If you have any questions or need help filling out the form contact: Dawn Kennedy at nominations@employerawards.ca or Phone: 604-220-5424 

Nomination Deadline:  August 31, 2016 by 5:00 pm

Let's get started!


In 'SECTION 4' you'll be asked if you have the business logo or photo of the employer and employee showing inclusiveness in the workplace. Upload them here, please indicate the employer or business you are representing in the 'Message' section of the file upload form. You can also download the 'Photo Release Form' beside it.  

Photo release form

Photo release form


SECTION 1
Inclusive Employer (Business) Nominee: Eligible Nominees must offer PAID employment
(To be used for publicity and award engraving)
Employer Address: *
Employer Address:
Employer Phone: *
Employer Phone:
http://
Check (one) if you know the Employer (Business) is: *
SECTION 2
Check the size of the business:
Business Size: *
SECTION 3
Nominator (Your) Information
Telephone: *
Telephone:
EXAMPLE: Sales Clerk / 3 years
SECTION 4
Do you have a copy of the business logo or photo of the employer and employee showing inclusiveness in the workplace?
1. Please use the UPLOAD FEATURE AT THE TOP OF THE PAGE OR email a copy of business logo to be used for media/marketing purposes to: nominations@employerawards.ca
OR
2. Please provide a photo of the employer and employee showing inclusiveness in the workplace. *
a. Please ensure everyone who appears in the photo submits a photo release form. Download at the top of the page or at: http://bit.do/employerawards
b. I give permission to the Inclusive Employer Awards to use business logo and/or photo in printed and online marketing materials.
Section 5
NOMINATION CRITERIA: Each question is worth 10 points. 5 points for the rating scale and 5 points for examples provided. Details = points!
On a scale of 1-5, please select how you rate the above sentence
Is there more than one employee with a disability? *
On a scale of 1-5, please select how you rate the above sentence
$ per hour and $ per year
On a scale of 1-5, please select how you rate the above sentence
On a scale of 1-5, please select how you rate the above sentence
On a scale of 1-5, please select how you rate the above sentence