NOMINATION FORM
Person
Nominated:
Please provide details of the person nominated
Name:
Position *:
Company *:
Country *:
Company headquarters :
( if different from above)
Contact Information:
Email *:
Phone Number *:
Type of product or service *:
Annual turnover:
No. of employees:
Please provide details of the nominator
Nominator’s name *:
Contact Information:
Email *:
Phone Number *:
Relationship to nominee *:
Summary
Provide an introductory summary of the initiative, policy or practice. Its main purpose, and how it is linked to the core business practices, objectives, activities and outputs, along with other relevant information, such as the main participants involved, the initiator, motivations and milestones. Highlight what has been accomplished, the obstacles encountered, and lessons learned. Please explain in particular the role of the business leader nominated.
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Role of the nominee
- Describe in detail the role of the nominee in designing and implementing the initiative, policy or practice. How nominee’s leadership skills encouraged and inspired others
- Provide information about knowledge and creativity of the nominee in addressing human trafficking within the business company and in community. How the nominee contributed to generating resources and taking action to address the problem.
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Efforts to combat human trafficking
- Describe in detail and provide evidence of the impact and effectiveness of the initiative, policy or practice. What change was implemented and how did it improve the situation. How did it impact operations of the company, e.g. internal procedures and processes, and the supply chain? How awareness on human trafficking was raised among employees?
- Provide details of how the initiative, policy or practice has
contributed to quantifiable progress, such as reducing the number of
persons trafficked or increasing the number of persons
rehabilitated.
- Show how awareness of human trafficking has been stimulated among
the business community at local, regional, national and/or
international levels as a result of the initiative, policy or
practice.
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Innovation in method
- In what way is the initiative, policy or practice innovative in
its approach?
- Is the initiative, policy or practice integrated into the
company’s corporate responsibility strategy? Please explain
- What impact will may the initiative, policy or practice have on how other businesses see their role in fighting human trafficking? How is it inspiring and motivating in finding new ways to combat human trafficking?
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Mobilizing multiple stakeholders
- How has the initiative, policy or practice set an example for
others?
- Describe how any other partners have been engaged in the
initiative, policy or practice including from the same or different
industry sectors, the public sector, the civil society
organizations, academia etc.
- How have these partners, if any, contributed to the success of the
initiative, policy or practice?
- How have good practices and key achievements of the initiative, policy or practice been communicated (e.g. training, advocacy, raising awareness), particularly among other businesses, government, local communities and civil society organizations? Did it inspire them to get involved and if so how?
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Vision
How will the initiative, policy or practice be developed in the future?
Where and how should further efforts be concentrated to replicate and scale up the initiative, policy or practice?
What lessons can be derived for the most effective ways to engage businesses in the fight against human trafficking?
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Other information
Provide details of individuals or organizations with
knowledge of the initiative, policy or practice and the nominee
who would be willing to act as a reference. A minimum of one
reference is required.
Additional Information such as project documents, brochures,
website address, awards received, media recognition, and
multimedia clips is optional.
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Contact
information
For more information on the Business Leader Award to Combat
Human Trafficking,
Please visit our website
www.businessleaderaward.org
For further queries concerning this form,
please contact
info@businessleaderaward.org
Please submit this completed form by 30 June 2012.