Award for Outstanding Major Donor – Nomination Form - AFP Quebec - Association of Professional Philanthropists

1. Information on the nominating organization

a. The person completing the nomination form

Name*

First name

Last name

Telephone*

Email*

b. The nominating organization

Name*

Mailing address*

Adress line 1

City

Province

Postal code

Registration number*

Telephone*

Email*

Founding year*

Number of employees*

2021 annual budget*

2020 annual budget*

Funding sources (check all of the options that represent 10% or more of your annual budget)*

Individual donations
Corporate donations
Subsidies
Events
Investment income
Membership fees
Other

If other, please specify : (max 10 words)

Sector*

Health
Education
Community
Arts and culture
Environment
Sports
Other

If other, please specify : (max 10 words)

c. Your mission (max. 50 words)

d. Provide a brief history of your activities and an overview of your concrete accomplishments. (max. 150 words)

2. Information on the candidate

Name*

First name

Last name

Téléphone*

Email*

Where have the candidate’s actions had the greatest impact?*

In Quebec
In Canada
Elsewhere in the world

Photo (max. 50 MB)*

Accepted file types: jpg, gif, png, Max. file size: 50 MB.

Present the candidate you are nominating by providing a brief biography that includes their career path, areas of interest and the causes they hold dear. (max. 150 words)*

3. Context of the donation

Present the genesis and scope of the candidate’s contribution to your organization. Provide any relevant information, being as specific as possible: situate the elements in time; describe your organization’s relationship with the donor, the donor’s contribution to your organization, and the circumstances surrounding the donation. (max. 250 words)*

4. Impact of the donation on your organization

Describe the concrete impact of this donation on your organization. Provide all of the relevant information, being as specific as possible: situate the elements in time; quantify the impact by stating the monetary amount or the percentage corresponding to your annual or events budget, if applicable; describe the difference this contribution concretely made to your capacity to offer programs and/or services; try to quantify the number of direct and indirect beneficiaries of this financial support. (max. 300 words)*

5. Exceptional nature of the donation

Describe the exceptional nature of the donation. How was it transformative for your organization? How did this financial support create a multiplier effect to the benefit your mission? In what way is the donor a catalyst for change within your community? (max. 200 words)*

6. Ethics and responsibility

Does this donation and its investment respect AFP Quebec’s standards of ethics and transparency, as stated in its Code of Conduct?*

Yes
No

Comments (max. 50 words)

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