If you know of an individual who deserves recognition for her/his outstanding contribution to wildlife conservation, please take the time to submit a nomination to:

Dr. Rick Riewe
Conservationist Awards Chair
c/o Zoology Department, U of MB
Winnipeg, MB R3T 2N2
Bus. 204-474-9768
Fax: 204-474-7588
E-mail: riewerr@Ms.UManitoba.CA

Deadline for Nominations:  March 10, 2005

Nominee:                  ______________________________________________________

Address:                   ______________________________________________________
                                 ______________________________________________________

Phone Number:         ______________________________________________________

Present Position:        ______________________________________________________

Academic Career:      ______________________________________________________
(use additional paper  ______________________________________________________
  if required)               ______________________________________________________

Professional Career:   ______________________________________________________
(use additional paper  ______________________________________________________
  if required)               ______________________________________________________

Nomination Statement:  Attach a type-written statement explaining why this individual is deserving of the Manitoba Chapter’s Conservationist Award.  Please explain the single accomplishment or series of accomplishments that places this individual above his/her peers.  Include information on other awards and honors received, TWS offices held, etc.  Any relevant news clippings, letters, documents for this nominee may be attached.

Submitted by:         ______________________________________________________

Address:                ______________________________________________________

Phone:                   ______________________________________________________