Sports Wall of Fame Nomination

Posthumous nominee *

Yes

Nominee information

Full name/Team name

Place of birth

Current address

Telephone(s)

Contact information for next-of-kin (if posthumous)

Full name

Relationship to nominee

Address

Telephone(s)

Nominee's personal information

Occupation

Dates of residence in Riverview

Name of spouse

Name of children

Competitive sport(s) in which the Nominee excelled:
Sport	Team	League	Dates (from-to)
Sport	Team	League	Dates (from-to)

Please summarize the Nominee's notable achievements and contributions to sport:

(Provincial/national/international level, awards and honours, championships, team names if applicable.)

Please upload any supporting documents that you wish the committee to consider

Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png pdf doc docx odt ppt pptx xls xlsx.

Contact information of person submitting the nomination

Full name

Address

Telephone(s)

Fax