Nomination Form

Name of Nominee: _____________________________________________

                                                        Surname                                        Given name(s)

Full Address: __________________________________________________

                                          Street and/or Box #                                                         City / Town           

  _________________________________________________

                                              Province                                        Postal Code                                 Phone Number

Education: ____________________________________________________

                                          Include name of school(s) and degrees obtained

Current Employment: ____________________________________________

                                                                                          Organization / Institution / Position

Other: ________________________________________________________

                            Place of Birth                               Date of Birth                                Date of Death (if applicable)

Nearest Relative: _______________________________________________

                                                        Name                                                               Phone Number                            

Name of Nominator: ____________________________________________

                                                            Surname                                        Given name(s)

Nominator’s Info: _______________________________________________

                                                            Organization / Institution / Position / Relation to nominee

                                 ________________________________________________

                                           City / Town                                Province                                Phone Number

I certify that all information included in this nomination form is correct.

I make this nomination because I feel that this individual or organization deserves recognition

for their outstanding contribution to the sustained growth and prosperity of Manitoba's

Canola industry.

________________________________________

Signature of Nominator

Please Note: The deadline for entries is November 16th, 2007.

Nominations received after the deadline date will be considered for the next year’s Canola Choice Award.

Mail or fax to:               2008 Manitoba Canola Choice Award

                                        Manitoba Canola Growers Association

                                       400 – 167 Lombard Ave

                                       Winnipeg, Manitoba   R3B 0T6

                                       Tel: (204) 982-2122      Fax: (204) 942-1841