6th Gawad Bayani ng Kalikasan

Honoring environmental heroes

Continuing the struggles for the people’s right to healthy ecology

NOMINATION FORM
Category: ❏ Individual ❏ Organizational
Name of Nominee:
Address:
Mobile Number:
Landline Number:
E-mail Address:

REQUIREMENTS

Below are the required and optional documents to be submitted by the nominators. Put a
check mark () on the box beside the documents that you are submitting. All documents must
not exceed a total of 30 pages. Submitted materials will no longer be returned. For articles
written in languages other than Filipino or English, please include a translated version. Note
that the nominator and the nominee cannot be the same person/organization.

For Individual Nominees: For Organizational Nominees:

Required documents to be submitted:
1. Nomination form
2. Biodata of nominee with pictures
3. Two (2) recommendation letters
4. One (1) page essay answering the
questionnaire in the second page
Optional:
 List of organizational affiliations,
positions held, awards and
recognitions, if applicable
 Published speeches, articles or other
documents, about the nominee
 Electronic copy of documentary video
or film (save in CD/USB or e-mail)
Required documents to be submitted:
1. Nomination form
2. Organizational profile or brochure
with pictures of the organization
3. Recommendation letters (2)
4. One (1) page essay answering the
questionnaire in the second page
Optional:
 List of affiliations, positions held,
awards and recognitions, if applicable
 Published speeches, articles or other
documents, about the organization
 Electronic copy of documentary video
or film (save in CD/USB or e-mail)

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 6th Gawad Bayani ng Kalikasan
Honoring environmental heroes
Continuing the struggles for the people’s right to healthy ecology

SENDING THE NOMINATION REQUIREMENTS

Send the requirements to the e-mail address gawad.bayani.ng.kalikasan@gmail.com

Deadline for the submission of nomination requirements is on AUGUST 3, 2020.

ESSAY QUESTIONNAIRE

Directions:

This essay aims to get to know the nominees to better. Write your answers in a concise manner
either in English or Filipino only. Write the answers below each question using Arial, font size
11, single spaced, and with 1-inch margins. The answers to sections A and B, including the
questions, should not be more than four (4) pages.

A. Nominee’s Information

What are the qualities of the nominee as a leader/leading organization? Has there been a
situation where the nominee’s principles and conviction challenged? How had the nominee
faced the situation? Is the nominee considered by others as a role model/organization and
source of inspiration? Please explain.

What successful programs, projects and/or activities were initiated and supported by the
nominee to help improve the poor people’s welfare or living conditions? (Please indicate results
and outcomes qualitatively and quantitatively, if possible) Presently, what are the obstacles,
risks and sacrifices that the nominee faces in accomplishing his/her/their work?

What are the successful programs, projects and/or activities initiated and supported by the
nominee to improve the local environmental situation? How has the nominee stood for the
protection of the environment and national patrimony? Please cite concrete situations. Has the
nominee been nominated or been a recipient of other citations, recognitions and awards in the
past? What are these?

What were the gains from the nominee’s involvements? How has the nominee’s work affected
the community, society, country and/or the world? Please sum-up the nominee’s contribution
in the struggle for the environment, peoples’ rights and national patrimony.

Should we want to know and get more information about your nominee could you give us two
names of individuals or organizations with their contact information?

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 6th Gawad Bayani ng Kalikasan
Honoring environmental heroes
Continuing the struggles for the people’s right to healthy ecology

B. Nominator’s Information

Name:
Organization: Position:
Birth Date: Gender:
Present Address:
Landline Number:
Mobile Number:
E-mail Address:
How are you related to the nominee (co-worker, relative, etc.)?
How long have you known the nominee?

The preceding information are submitted to the best of my knowledge, to nominate

(name of nominee) in the Individual / Organizational Category of the 6th Gawad Bayani ng
Kalikasan.

Nominator’s Name: ______________________

Signature: _____________________________
Date: _________________________________

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