2021 NOMINATION FORM

CATEGORY 3

Best photo: connecting Canadians (public voting category)

We’re looking for glorious photos of CCSA Member companies. From working on special projects to showcasing team members, to celebrating community – we want to see it!

Entry information

Your full name:*
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I am a/an:*
of the following local provider of television and/or communication services:*
Are you (or is a member of your immediate family) a CCSA employee or contractor?*
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- No
Do you agree to the contest rules as posted on the Tuned-in Canada website?*
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Nominee information
Please upload your Connecting Canadians photo now:
Please give us a caption that describes what is happening in the photo.*
If you are aware of the name(s) of anyone featured in the photo(s), please feel free to share their names with us:
Video/Photo release form (if you are sending us a photo or video): I hereby certify that I own the rights to the supplied photo(s) and video content, and give permission to the CCSA for its use on the web and in print materials for the purposes of promoting my nominee and Tuned-in Canada: The CCSA Awards. In addition, I waive the right to inspect or approve the finished product, including written and electronic copy. I hereby hold harmless and release and forever discharge the CCSA from all claims, demands and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have in connection with this authorization. By clicking I ACCEPT below I indicate that I have read and fully understand the contents, meaning and impact of this release.*
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2021 NOMINATION FORM

CATEGORY 3 Best photo: connecting Canadians (public voting category)

Entry information

Nominee information

CATEGORY 3

Best photo: connecting Canadians (public voting category)