Emergency Management Exemplary Service Award
Nominee form

Instructions to the Nominee

You are being nominated for a Federal/Provincial/Territorial (F/P/T) Emergency Management Exemplary Service Award in recognition of your contributions to emergency management in Canada. Collection and use of personal information as set out and explained further in this document is necessary to complete the process in support of your nomination. In order to proceed, your consent for the collection and use of your personal information is required.

We would ask that you please read this form carefully. Providing your signature at the end of this form will confirm that you agree to the collection of personal information and understand how information about you will be used to support your nomination.

In the event that the nominated individual is a minor (under the age of majority in the jurisdiction of residence of the nominee), the nominee's parent or legal guardian must sign this form and indicate that he/she is providing this consent on behalf of the minor being nominated.

For a posthumous nomination, the nominee's executor is required to sign this form and indicate that he/she is providing this consent on behalf of the estate.

Preferred Language
English
Français

Preferred Salutation
(Title, Mr., Mrs., Ms., etc.)

Name
(First, Middle Initial, Last)

Please include your contact information so that we may contact you regarding your nomination:

Home Address
Apt. no, Street no., Street P.O. Box, R.R.
Municipality Province/Territory Postal Code

Daytime Telephone

Alternate Telephone

Personal e-mail

Work e-mail

Please indicate the name of the nominator:

1. Background Information

Efforts to improve community safety and resilience are usually the work of many people over time. On occasion, it is possible to single out individuals and groups to be acknowledged by their peers and Canadian society for exemplary conduct, actions and leadership as emergency management professionals.

Nominees for the Emergency Management Exemplary Service Award have distinguished themselves through their actions and contributions to advancing emergency management in Canada—to save lives, preserve the environment and protect property and the economy.

Successful nominations will reflect a sustained commitment to excellence in emergency management programming that is recognized by their peers, or one or more highly significant contributions that are seen by emergency management leaders in Canada as worthy of national recognition. Criteria are defined further in Section 2 Eligibility—below the following definition of "emergency management" for Canada:

Emergency Management

The Emergency Management Framework for Canada defines "emergency management" as "the management of emergencies concerning all-hazards, including all activities and risk management measures related to prevention and mitigation, preparedness, response and recovery."

Prevention and Mitigation
to adapt to, eliminate, or reduce the risks of disasters in order to protect lives, property, the environment, and reduce economic disruption. Prevention/ mitigation includes structural mitigative measures (e.g. construction of floodways and dykes), and non-structural mitigative measures (e.g. building codes, land-use planning, and insurance incentives). Prevention and mitigation may be considered independently or one may include the other.
Preparedness
to be ready to respond to a disaster and manage its consequences through measures taken prior to an event, for example emergency response plans, mutual assistance agreements, resource inventories and training, public awareness activities, equipment and exercise programs.
Response
to act during, immediately before or after a disaster to manage its consequences through, for example, emergency public communication, search and rescue, emergency medical assistance and evacuation to minimize suffering and losses associated with disasters.
Recovery
to repair or restore conditions to an acceptable level through measures taken after a disaster, for example return of evacuees, trauma counseling, reconstruction, economic impact studies and financial assistance. There is a strong relationship between long-term sustainable recovery and prevention and mitigation of future disasters. Recovery programs provide a valuable opportunity to develop and implement measures to strengthen resilience, including by building back better. Recovery efforts should be conducted with a view towards disaster risk reduction.

2. Eligibility

Any person working/volunteering in the field of emergency management in Canada is eligible.

Nominees for the Emergency Management Exemplary Service Award may be emergency management professionals from any level of government (federal, provincial or territorial, municipal [upper/lower tier, county, city etc.]), Indigenous communities, a non-governmental organization, academia or an association, who have demonstrated exemplary service in the field of emergency management.

In order to complete the nomination package, the party putting forward the nomination will be required to provide 2 testimonials which support notable career achievements, including professional and volunteer activities and their significance.

The parties providing testimonials will be asked to provide clear examples of your contributions using some or all of the following attributes:

For additional eligibility details for each category, please see the website for the Emergency ManagementExemplary Service Award.

3. Evaluation Process

Federal, Provincial, Territorial (F/P/T) jurisdictions, Search and Rescue, and their selection committees will review and choose nominations to put forward to the F/P/T Senior Officials Responsible for Emergency Management.

SOREM will review and be asked to endorse the list of nominees put forward by each jurisdiction for the Emergency Management Exemplary Service Award.
All documents provided in support of the nomination for the Emergency Management Exemplary Service Award will be handled in accordance with the requirements of the applicable Privacy legislation.

4. Nomination Checklist (to be provided by the Nominator)

5. Privacy Notice Statement

Public Safety Canada is committed to protecting the privacy rights of individuals and safeguarding the personal information under its control according to the Privacy Act.

All personal information collected as part of the nomination process will be used solely for the purpose of assessing and completing the nomination. Personal information will be disclosed to other government departments (Federal/ Provincial/Territorial), and non-governmental organizations for the purpose of the selection process. Participation in the nomination process is voluntary. Should you refuse to provide the necessary information, your nomination cannot be accepted. In the event you are a successful recipient of the Award, Public Safety Canada may use the personal information you provide to publish your name and summary of achievements as a winner of this award on the Emergency Management Exemplary Service Award webpage and/or to promote the award via social media.

Other government departments (Federal/Provincial/Territorial), and non-governmental organizations that are directly involved with the nomination may also choose to publish your personal information related to the award.

This information is collected and used under the authority of the Department of Public Safety and Emergency Preparedness Act and the Emergency Management Act. For more information about the collection, use and retention of your personal information, please refer to the Personal Information Bank Emergency Management Exemplary Service Award (PS PPU 08).

You have the right to the protection of, access to and correction of your personal information. Instructions for obtaining this information is outlined on the Public Safety Canada Access to Information and Privacy (ATIP) website.

Any questions, comments, concerns or complaints you may have regarding Public Safety Canada's handling of your personal information may be directed to our Access to Information and Privacy Coordinator by emailing atip-aiprp@ps-sp.gc.ca. If you are not satisfied with Public Safety's response to your privacy concern, you have the right to file a complaint with the Privacy Commissioner of Canada regarding the institution's handling of your personal information.

6. Consent

A. Consent to participate in the administration and nomination process

In order to complete the nomination process and to forward your nomination for consideration, your consent is required for the indirect collection of your personal information from a nominator or an individual chosen by the party making the nomination (hereinafter referred to as "nominator"). Your nominator will be providing a testimonial which will include information about you, including but not limited to, your story, information about your accomplishments, your professional achievements, your exemplary standards and/or any other information needed to meet the merit criteria as listed in Section 2 of this form.

Your participation in this nomination process is voluntary. Should you refuse to provide your personal information for the purpose of assessing and completing your nomination, you will not be considered for the Emergency Management Exemplary Service Award.

If you do not wish to provide your consent or to be considered for the Emergency Management Exemplary Service Award, please notify your nominator immediately so that your name can be removed from consideration.

I, (name of nominee), confirm that I have read and understand the information contained in this document and provide my consent for the indirect collection and use of my personal information in support of my nomination and subsequent consideration for the Emergency Management Exemplary Service Award.

I agree to accept this nomination

Signature
Date

B. Consent to use your name and achievements should you be selected

Your consent is required to have your name and a summary of your achievements for nomination shared publicly on the Emergency Management Exemplary Service Award webpage and to promote the awards via social media should you receive the Emergency Management Exemplary Service Award.

Providing consent to having your information shared once you have won the award is voluntary and will not impact your likelihood to win the Emergency Management Exemplary Service Award.

If you do not wish to provide your consent to share your information for these purposes, please notify us immediately to ensure your information is not published on the webpage or social media.

I, (name of nominee), acknowledge and understand that the names of the recipients of the Emergency Management Exemplary Service Award will be made public and in the event that I am chosen as a recipient of the award, I agree to have my name made public.

Signature
Date

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