Nomination Form

Please note: The fields marked * are mandatory.
Nominee's Name*
Contact information of Nominee
Recognition Category*




Awards Received By Nominee*
Relationship to Brampton*
Minimum 5 years in the industry*
General Comments
Your Name*
Your Phone Number*
Your Email*
Attachments
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Privacy Statement

The personal information on this form is collected under authority of the Municipal Act SO 2001, c. 25. Questions about the collection of personal information should be directed to our Call Centre by dialing 3-1-1 (within Brampton city limits) or 905.874.2000 (outside city limits). Please review the City’s Privacy Statement for more information.