2016 Dr. Dayton M. Forman Memorial Award
Official Nomination Form
This award, established by the CNIB Library board of directors in January 1996, recognizes outstanding leadership in the advancement of library and information services for Canadians who are living with vision loss. It is offered in tribute to Dr. Dayton M. Forman, an exceptional humanitarian and longstanding CNIB volunteer, who exemplified the leadership required to make a difference for over half a million people across Canada living with vision loss.
The recipient is awarded a silver medal bearing the likeness of Dr. Forman and an inscription in print and braille.
NOMINEE (individual or organization):
Address:
Name of contact person (if nominee is an organization):
Telephone:
Fax:
E-mail:
The nomination for the Dr. Dayton M. Forman Memorial Award must be supported by TWO individuals and/or organizations.
1. NOMINATED BY (individual or organization):
Address:
Name of contact person (if nominator is an organization):
Relationship to nominee:
Telephone:
Fax:
E-mail:
Signature:
2. NOMINATED BY (individual or organization):
Address:
Name of contact person (if nominator is an organization):
Telephone:
Fax:
E-mail:
Signature:
For the nomination of an individual:
____ The work that the nominee has done in relation to this nomination has been as a volunteer.
____ The nominee works for a business or organization involved with providing services for people who are living with vision loss.
____ Both of the above.
For the nomination of an organization:
____ The nominee provides services for people who are living with vision loss.
____ The nominee supports volunteerism in library services for people who are living with vision loss.
Please answer each of the following questions with a statement of 100 words or less.
1. If the nominee is an individual, please list the organizations that he or she has worked for, along with the dates worked and positions held. Please only include positions that relate to the nominee’s contributions towards library services for people who have vision loss.
2. If the nominee is an organization, please briefly describe the organization and its goals/mission.
3. Describe the barrier(s) to information equity that the nominee’s efforts have addressed.
4. Describe the nominee’s motivations or reasons for working to address these barriers.
5. How have the nominee’s efforts had an impact on library and/or information services for people who have vision loss in Canada? Please describe and then provide one or two examples.
6. Describe the possible long-term outcomes of the nominee’s efforts.
7. Please describe the nominee’s leadership qualities.
8. Describe how the nominee has shown initiative or been innovative in addressing the reading or information needs of Canadians who have vision loss.
9. Has the nominee received any previous awards that relate to library or information services for Canadians who are living with vision loss? If so, please list.
Additional documentation in support of a nomination is not necessary, but is welcome (please submit by e-mail if possible).
Please forward the application and any additional documentation on or before September 2, 2016, to:
The Dr. Dayton M. Forman Memorial Award Selection Committee,
CNIB Library,
1929 Bayview Avenue,
Toronto, ON, Canada,
M4G 3E8.
Fax: (416) 480-7700
E-mail:
Submissions by e-mail are encouraged.
Questions?
Please contact the CNIB Library at the above e-mail address or at (416) 486-2500 x 7522
This year’s award presentation will take place on Friday, October 21, 2016, at a network reception held in conjunction with the CNIB 2016 Braille Conference in Toronto, Ontario.