Required fields are marked with asterisks (*)

City of Waterloo Senior of the Year Nomination Form

This form, completed in its entirety, must be received by 4:00 p.m. on March 31, 2026.

If you have questions about filling out this form, please email agefriendly@waterloo.ca or call 519-747-8725 and a staff person will be happy to help you.

Eligibility for Senior of the Year Award

The nominee must be:

65 years of age
a current resident of Waterloo
made volunteer contributions to improve the Waterloo community
give permission to be nominated and verify the information submitted is accurate

Recognition of recipient and nominees

Waterloo's Senior of the Year Award will be presented at an event on May 28, 2026. All nominees, their nominators and guests will be invited to attend.

Nominee information

Person nominated for consideration as City of Waterloo Senior of the Year.

Full name (first and last)

Street address

City

Province

Postal code (format is A1A 1A1)

Email address if available

Phone number

Nominator contact information

Person submitting the nomination.

Your full name (first and last)

Street address

City

Province

Postal code (format is A1A 1A1)

Email address

Phone number

Organization (if applicable)

Submission information

1. Tell us about the organizations or individuals your nominee supports, including role and length of service.

2. Describe how volunteer contributions made by your nominee have impacted an individual, group or the greater community.

3. Describe how your nominee has acted as a role model or inspiration for others.

4. Share anything else you would like us to know about your nominee’s accomplishments, volunteer contributions, or impact in the community.

Supporting documents

Up to 2 testimonial letters from those who know the nominee and can speak to their contributions or impact of their actions
Optional: up to two news articles or links to online stories or videos that provide further information about the nominee (if applicable)

Upload supporting documents here

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Nominator agreement

By Checking “Yes, I agree” I agree that the nominee is a Waterloo resident at least 65 years of age and is aware of this nomination and the submission information being provided:

Yes, I agree

No, I disagree

Please tell us how you learned about the Waterloo Senior of the Year Award (check all that apply)

Newspaper - print or digital

Social media (Facebook, Instagram, X [Twitter], LinkedIn)

Poster/postcard

Word of mouth

E-newsletter

Other

Forms