Butterfly Project Application

The nomination period will be open for a period of 3 months beginning January 1, 2019 and will close on March 15, 2019.

Nominator Information

What is your first name?
What is your last name?
What is your phone number?
What is your email?

Does the Nominee know they are being nominated?*


Nominee's Information

What is the nominee's first name?
What is the nominee's last name?

Are they 18 years of age or older?*

What city does the nominee live in?
What is the nominee's phone number?
What is the nominee's email?

Important:

The Butterfly Project will not be able to proceed with the nomination without an accurate email and phone number for the Nominee.

What is the nominee's occupation?
What is the nominee's education level?
How many children does the nominee have?

Child #1

What is child #1's first name?
What is child #1's age?

Child #2

What is child #2's first name?
What is child #2's age?

Child #3

What is child #3's first name?
What is child #3's age?

Child #4

What is child #4's first name?
What is child #4's age?

Important:

A background check will be required for all shortlisted candidates.

Note: The Butterfly Project will cover any costs associated with this requirement. Proof of identity is required for shortlisted candidates.

What is your relationship to the nominee?
How long have you known the nominee?

The Nominee to be considered as a stronger candidate, Nominator will have known the Nominee for at least 1 year. If the Nominator has not knownthe Nominee personally for a year or more, the Nominator must make a case that they have sufficient knowledge of the Nominee's circumstances in the nomination form. And if this is the case, that the Nominator has known the Nominee for less than a year, the Nomination Committee may consider this as a factor in deciding upon the recipient of the award.

How long has the nominee been a single parent?
Why should they be selected?
Any other information we should know?