Woolwich CARES Nomination Form

Please complete the form below.

Company Name

Type of Business

Address

Contact Name

Title

Phone

Project/Initiative Name

Start Date

Completion Date

Project/Initiative Description

Please explain the reason/rationale for implementing this project.

Did the project / initiative benefit from any government or third party incentives, inducements, tax benefits, etc.? If so, please identify the effect they had on the project

Information collected on this form will be used for the purposes of determining the suitability of a project or initiative for the Woolwich Cares Business Leadership Award. However, some information may be disclosed publicly as part of the Award selection process and publication of the Awards. This information may include, but is not limited to, the company name, key employees involved in the project, the project name, a description of the project, project timeframes, the value of the project, the identified benefits to Woolwich Township and its residents, and the reasons for undertaking the project.

The personal information collected on this form is subject to the restrictions of the Municipal Freedom of Information and Protection of Privacy Act and will onle be used for the purposes of Woolwich CARES Business Leadership Award nomination and selection.

Applications will be accepted each year until February 28.