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Athlete Nomination Form

Athlete Nomination

This field is for validation purposes and should be left unchanged.

Part A - Nominee Information

Mailing Address(Required)
MM slash DD slash YYYY
MM slash DD slash YYYY
Next of Kin Mailing Address (if applicable)

Nominator Information

MM slash DD slash YYYY

PART B - Participation as an Athlete

Please list details of nominee’s competitive/meritous career as an athlete, including competition names/events, dates and locations, status or results in each category listed below:

International Level: (Olympics, Worlds, International meets)
Date(s)
Level/Competition Name
Location
# of Competitors
Status/Result
 
National Level results
Date(s)
Level/Competition Name
Location
# of Competitors
Status/Result
 
Western Canada results
Date(s)
Level/Competition Name
Location
# of Competitors
Status/Result
 
Provincial Canada results
Date(s)
Level/Competition Name
Location
# of Competitors
Status/Result
 
Local/Regional results
Date(s)
Level/Competition Name
Location
# of Competitors
Status/Result
 
Please provide any Provincial, National or International organization/affiliation or competition websites or contact information should results information need to be verified as part of nomination process.

Part C - Accomplishments as an Athlete

Local/Regional results
Award/Honour
Date Received
 
Please list any awards and honors bestowed upon the nominee during their athletic career with dates. Examples: MVP most valuable player, All-star selection, other Hall of Fame or prestigious awards.
Athletic versatility (other sports, awards)
Sport
Player/Role
Awards/Honours
Date Received
 
Please list the nominee’s involvement in other sports and any merits/awards received in those sports.
Please describe the nominee’s demonstrated character, sportsmanship and their involvement and connection in the community with respect to sport. Examples: volunteer experiences, involvement in building sport development, mentoring opportunities, giving back to others and demonstrating qualities of leadership, sportsmanship or community service). *Letters of support from peers, coaches, sport, or associations affiliated to (not friends/family), newspaper articles, etc. may be included and should directly relate to the nominee’s accomplishments and/or character.

Closing - Storyboard Bio & Photo of Athlete

In the space provided, in 500 words or less summarize the Athlete/Nominee’s introduction for their storyboard which is displayed as part of the Lac La Biche County Sports Hall of Fame. Highlight key accomplishments, awards, and chain of events in chronological order with dates which led to their overall success during their athletic career and speaks to their character. *Lac La Biche County may edit text for grammar, length and consistency to create personal story and will send final for review for approval prior to production.
Accepted file types: jpg, tiff, png, webp, Max. file size: 50 MB.
Consent(Required)