Pharmacists Manitoba

Bowl of Hygeia Nomination Form

The Bowl of Hygeia Award is presented in recognition of the time and personal sacrifice devoted by pharmacists to the welfare of their respective community. This award was established in 1958 and awarded to a pharmacist for outstanding community service.

Eligibility Criteria
This award is presented to a pharmacist based on outstanding service to the community. The recipient must:

The recipient must be a pharmacist, licensed in Manitoba
Awards are not presented posthumously.
The recipient has not previously received the award.
The recipient is not currently serving, nor has he/she served with the immediate past two years, on its awards committee or as an officer of the association in other as an ex officio capacity.
The recipient has an outstanding record of community service, which apart from his/her specific identification as a pharmacist, reflects well on the profession.

Nomination Details
The nomination should include the following:

Description of the nominee’s involvement in community service.
Description of the activities and organizations the nominee is involved with and the impact they have had with/on each.
Description of how the nominee’s community involvement reflects on the profession of pharmacy.

First Name *

Last Name *

Email *

Nominating Person's Contact Information

First Name: *

Last Name: *

Email Address: *

Telephone Number: *

Nominee's Contact Information

First Name: *

Last Name: *

Email Address: *

Telephone Number: *

To support your nomination, please answer the questions below to the best of your ability. As part of the nomination package, please submit supporting documentation (e.g. newspaper articles, reference letters, certificates of achievement, CV or biography etc.) Up to three supporting documents can accompany the nomination.

Describe the nominee's involvement in community service: *

Describe the activities and organizations the nominee is involved with and the impact they have had with/on each: *

Describe how the nominee's community involvement reflects on the profession of pharmacy: *

Supporting Document # 1

Supporting Document # 2

Supporting Document # 3