Women in Mining Canada Indigenous Trailblazer Award Nominator InformationPlease enter the Nominator's contact information.Name(Required) First Name Last Name Email address(Required) Email Confirm Email Phone number(Required)How did you hear about the Indigenous Trailblazer Award?(Required) Women in Mining Canada mailing list Women in Mining regional chapter mailing list Women in Mining Canada social media Women in Mining regional chapter social media Communications from a community leader Coworkers/colleagues Friend or personal network Other Is the Nominator also the Nominee?(Required) Yes No Would you like WIM Canada to keep this nomination on file for up to three years?(Required)Any new nomination will replace the saved nomination, otherwise the saved nomination will be considered for the Award. Yes No Nominee InformationPlease enter the Nominee's contact informationName(Required) First Name Last Name Email address(Required) Email Confirm Email Phone number(Required)ApplicationPlease fill out the following section to submit the application documentation.Please submit the Nominee's CV(Required) Drop files here or Select files Max. file size: 256 MB, Max. files: 1. Please submit your cover letter(Required) Drop files here or Select files Max. file size: 256 MB, Max. files: 1. Please submit up to three (3) letters of support(Required) Drop files here or Select files Max. file size: 256 MB, Max. files: 3. Additional InformationThis section is optional. The information will only be used in the case that the Nominee wins.Please submit a short bio (max. 250 words) about the Nominee Drop files here or Select files Max. file size: 256 MB, Max. files: 1. Please submit a photo of the Nominee Drop files here or Select files Max. file size: 256 MB, Max. files: 1. Please share the Nominee's LinkedIn profile DemographicsThis section is optional. This information will only be used for statistical purposes.Nominator gender Man Woman Non-binary Two-spirit Prefer not to identify Other Nominator ethnicity Asian Black Caucasian Indigenous Latinx Middle Eastern Mixed ethnicity South or Southeast Asian Prefer not to identify Other Nominee age <25 26-30 31-40 41-50 51+ Not sure Prefer not to say Nominator age <25 26-30 31-40 41-50 51+ Prefer not to say Nominee Indigenous status First Nation Inuit Métis Not sure Prefer not to identify Not Indigenous Nominator Indigenous status First Nation Inuit Métis Prefer not to identify Not Indigenous Nominee location Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Not sure Prefer not to say Other Nominator location Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Prefer not to say Other
