Manitoba Chapter Conservation Award
Nomination Form

If you know of an individual or organization that deserves recognition for their outstanding contribution to wildlife conservation in Manitoba, please nominate them for a Conservationist Award by filling out the following nomination form and pressing SUBMIT.

INFORMATION FOR INDIVIDUAL OR ORGANIZATION BEING NOMINATED
Nominee's Name *
Nominee's Name
List organization, title and location, and provide a brief description of responsibilities in this role
List institutions, departments, degrees and thesis title(s)
List organizations, positions and locations, and provide a brief description of duties in each role.
NOMINATOR(S) INFORMATION
Nominator(s) Phone Number(s)