Athletics Award

2. Name, team or group of nominee*

4. Full address of nominee*

6. Phone # of nominee*

7. Email of nominee

9. Level of competition: *
   -- Select One --Provincial National International Other

10. Date & location of achievement *

12. Describe the outstanding achievement of nominee(s):*

14. Additional documents

    Additional documents may be attached to complete your submission. The Selection Committee reserves the right to assign a nomination to an alternate category, provided the nominator agrees to the reassignment.

    Additional documents may be attached to complete your submission. The Selection Committee reserves the right to assign a nomination to an alternate category, provided the nominator agrees to the reassignment.

16. Upload additional documents

18. Name of nominator *

    A nominator may not be a member of the nominee's immediate family.

20. Full address of nominator *

22. Phone # of nominator *

23. Email of nominator

25. Signature of nominator*

    Type your name in lieu of signature

27. Name of seconder*

29. Full address of seconder *

31. Phone # of seconder*

32. Email of seconder

34. Signature of seconder*

    Type your name in lieu of a signature.

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35. 1. Receive an email copy of this form.
36. Email address

    This field is not part of the form submission.

37. Submit

* indicates a required field