NOMINATOR:
*Name (or organization):
Telephone:
Address:
City:
Province:
Postal Code:
*Email:
NOMINEE:
*Name (in full):
Telephone:
Address :
City :
Province :
Postal Code :
Email :
Nickname (if applicable):
Date of Birth (day/month/year):
Place of Birth:
If deceased: Date (day/month/year):
Where:
NEXT OF KIN:
Name:
Telephone :
Address :
City :
Province :
Postal Code:
Email :
NOMINATION CATEGORY: (check one only)
The above individual or team to be nominated in the following category:
Category:	Athlete (include Builder activities if any) Builder (include athletic activities, if any) Team (include official roster of names)
Still active as Athlete? (Y/N):
Still active as Builder? (Y/N):
Nomination submissions MUST include the following:
- Nomination Form. This form must accompany all nomination submissions.
- Resume. An accurate and detailed account of nominee’s activities, include all activities in sports (athletic and/or building). Be sure to include dates, location, level of activity, championships/awards achieved. For team include official team roster.
- Documentation. Proof of achievement(s), include newspaper articles: photographs; scrapbooks; programs; minute books; video etc. Have all documentation dated. Maximum of six pages of photocopied information will be accepted.
- Photograph – 8 X 10 photo of nominee, suitable for reproduction.
NOMINATIONS CANNOT BE ACCEPTED WITHOUT ABOVE LISTED INFORMATION
Mailing Address:
Ottawa Sports Hall of Fame
632 Glenhurst Crescent
Ottawa, ON K1J 7B7
Telephone: 613-747-9865
Fax: 902-484-7518
DEADLINE: February 28th