Canadian Forces Liaison Council Employer / Educator Support Award Nomination Instructions: Please include all information requested on this form. We cannot process your nomination without complete information. Do not use any abbreviations and limit the use of acronyms. If acronyms are used, please spell out the acronym in the first instance followed by the accepted acronym in parentheses. I.E. "Canadian Forces Liaison Council (CFLC)" The completed form is to be submitted to CFLC@forces.gc.ca . Section I: Organization Information Full name and title of Employer / Educator to be nominated (as it is to appear on an award): Organization full official name (as it is to appear on an award): Organization's point of contact Info: Prefix: Surname: Given Name: Post Nominals: phone number: email: Street Name: Street number: Unit/Floor Number: City: Province: AB BC MB NB NL NS NU NT ON PE QC SK YT Postal Code: Website URL: Social Media Site(s): Industry Sector: Construction Defence Industry Municipal Government Provincial Government Federal Government Police Fire Services EMS Security Utilities Wholesale and Retail Sales Non-Profit / Charity Post-Secondary Education Accounting, Finance and Insurance Real Estate and Rental and Leasing Mining, Oil and Gas Manufacturing Retired or Self-Employed Management / Consulting Services Media, Information and Cultural Industry School Board Primary and Secondary Education Transportation, Distribution, Logistics and Warehousing Waste Management and Remediation Services Health Care and Social Assistance Arts, Entertainment and Recreation Hospitality, Accommodation and Food Services Agriculture, Forestry, Fishing and Hunting Communication and Information Technology Engineering, Professional, Scientific & Technical Services Other:Explain below_______________ Number of Employees in the Organization: Less than 5 5 to 10 10-20 20-30 30-40 40-50 Greater than 50 Number of Reservists employed by Company. If unknown, state "unknown": Less than 5 5 to 10 10-20 20-30 30-40 40-50 Greater than 50 Please check-off or detail in the space below your knowledge of your organization’s / academic institution’s reservist-friendly human resources policies: Students: Has a written policy that allows for special accommodations for students on military service Grants extensions on assignments Reschedules exams or makes arrangements to administer exams while students are on training or operations Has a Leave of Absence Program so reservists can deploy Makes special registration arrangements or waives late registration penalties due to military service Defers grants, scholarships to allow for deployments or training Granted educational credits for military courses or job-experience Other – please use the box below Employee: Grants leave for military operations Grants leave for military training Grants leave on short notice Tops up pay Maintains employee benefits while on military service? Encourage their employees to continue their involvement in the Reserves Other – please use the box below Other: Section II: Nominator Information Rank: Surname: Given Name: Post Nominals: Email Address: Daytime Telephone: Home Address: Home City: Province: AB BC MB NB NL NS NU NT ON PE QC SK YT Home Postal Code: Nominator’s Environment: Navy Army Air Nominator’s Sub-Component: Naval Reserve Army Reserve Air Reserve Health Services Reserve Legal Services Reserve CANSOFCOM Reserve COATS Canadian Rangers Supplementary Reserve Nominator’s unit position: Unit Name (in full): Unit Address: Unit City: Unit Province: AB BC MB NB NL NS NU NT ON PE QC SK YT Unit Postal Code: Commanding Officer Info Rank: Gen/Adm LGen/VAdm MGen/RAdm BGen/Cmdre Col/Capt(N) LCol/Cdr Capt/Lt(N) Lt/SLt 2Lt/ASLT OCdt/NCdt CWO/CPO1 MWO/CP02 WO/PO1 Sgt/PO2 MCpl/MS Cpl/LS Pte/OS Surname: Given Name: Post Nominals: Section III: Citation (maximum 200 words) Tips for drafting your citation: Successful nominations typically have a clear and concise citation. To best achieve this, we recommend you draft your citation separately, have it carefully proof-read by another person, such as your supervisor or your CFLC Unit Employer Support Rep, and then cut-and-paste it in the block below. Describe clearly why this organization should receive recognition under the Employer Support Awards Program. The following factors are provided to assist you with formulating your citation: 1. In broad terms, how is your employer/academic institution committed to supporting you in maintaining your military commitments? 2. Describe how your organization has supported Reservists over a sustained period, or a special effort, to enable you to complete your military commitments? Please provide specific examples. 3. Describe how your organization’s culture has directly enabled you to balance work, military and family commitments. 4. As it applies, identify the name of the operation or course you attended, where you were most notably supported. Describe the nature of the mission / task and the relevance of your role to mission success during this commitment. 5. Describe any specific support that was provided to you or your family by your employer / academic institution, when you were on military leave. 6. Any other notable measures or policies that are in place that positively support the military commitments of Reservists in your organization. Section IV: Acknowledgement and Release By clicking on the “submit” button, I hereby authorize CFLC to contact my employer or educational institution and my military unit regarding this nomination and their support of the Reserve Force and refer to me, by name if necessary. I understand that my photo, and any information within this nomination may be published and shared to support and advertise the Canadian Armed Forces and the Reserve Force. Rank: Gen/Adm LGen/VAdm MGen/RAdm BGen/Cmdre Col/Capt(N) LCol/Cdr Capt/Lt(N) Lt/SLt 2Lt/ASLT OCdt/NCdt CWO/CPO1 MWO/CP02 WO/PO1 Sgt/PO2 MCpl/MS Cpl/LS Pte/OS Surname: First Name: Date: The completed form is to be submitted to CFLC@forces.gc.ca .