Canadian Hospice Palliative Care Association > About The Canadian Hospice Palliative Care Association > Awards > Balfour Mount Champion Award > Balfour Mount Champions Award – Nomination Form

Balfour Mount Champions Award – Nomination Form

  • Nominee

  • Contact Information for Nominee

  • Balfour Mount Champion Award: Eligibility Criteria

  • Please ensure that the nominee meets the following criteria prior to submitting the nomination form for consideration by the CHPCA Board. The nominated individual, company or organization has fulfilled the following criteria:
    • Advances hospice palliative and end-of-life care, awareness and advocacy in Canada;
    • Operates either internally or externally from the traditional hospice palliative care field;
    • Has championed the cause broadly at a national level;
    • Is a Canadian citizen or a company or organization that operates primarily in Canada;
    • Has made a difference in the quality of life of Canadian individuals and families facing life-threatening illness and bereavement.

  • Presentation of Award

  • It is preferred but not required that the nominee is in attendance at the CHPCA Opening Ceremonies to accept the award if selected. The 2021 National Conference is being held online due to Covid-19.

  • Nominee Background Information

  • Based on the eligibility criteria, please completely answer all of the following questions.
  • This field is for validation purposes and should be left unchanged.
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