Team Nomination Form - Bold Centre

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Part A - Team Information

Team Name(Required)

Sport(Required)

Year(s) of team to be honoured(Required)

A minimum of 5 years must have passed since the event for which the team is nominated

Was the competition restricted by age?(Required)

Yes

Was there a minimum age?(Required)

Yes

Please specify the minimum age(Required)

Was there a maximum age?(Required)

Yes

Please specify the maximum age(Required)

What was the name of the age category in that sport?(Required)

Vocation of Teams' Status (please check) Affiliation(Required)

Other - Please indicate affiliation(Required)

Number of team members(Required)

Number of team members that resided in Lac La Biche County during playing year(s):(Required)

Number of team players born in Lac La Biche County:(Required)

Primary Team Representative Contact:

Name(Required)

Affiliation with Team(Required)

Mailing Address

Street Address City ZIP / Postal Code

Telephone (Primary):(Required)

Telephone (Secondary):

Email Address

Secondary Team Representative Contact (If Applicable):

Name (If Applicable)

Affiliation with Team (If Applicable)

Mailing Address (If Applicable)

Street Address City ZIP / Postal Code

Telephone (Primary) (If Applicable):

Telephone (Secondary) (If Applicable):

Email Address (If Applicable)

I consent to the team nomination being submitted for the Lac La Biche County Sports Hall of Fame. I have reviewed the content of this nomination and declare that the information included is true and correct and have authority to accept the nomination on behalf of the team being nominated.

I consent

Nominator Information

Nominator Name(Required)

Relationship to Nominee:(Required)

Telephone (Primary):(Required)

Telephone (Secondary):

Email Address(Required)

PART B:

Roster: please include names, birth dates, playing positions for all players, coaches, managers, and any additional team personnel and deceased dates (if applicable).

First Name

Last Name

Birth date (dd/mm/year)

Position / Role

Deceased Date (If Applicable)

Upload Team Roster (Optional)

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Max. file size: 50 MB.

Team Information:

In what year was the team formed?(Required)

Were players not on the team during the qualification competition added to the team for the national/international championship?(Required)

Yes

If yes, please explain:(Required)

Describe the competition format and achievements/titles the team accumulated during their tenure.

International Level: (Olympics, Worlds, International meets)

Date

Level / Competition

Location

# of Teams

Status / Result

National Level:

Date

Level / Competition

Location

# of Teams

Status / Result

Western Canada:

Date

Level / Competition

Location

# of Teams

Status / Result

Provincial Level:

Date

Level / Competition

Location

# of Teams

Status / Result

Regional / Other:

Date

Level / Competition

Location

# of Teams

Status / Result

Affiliation Requirements

Include provincial sport governing body team was affiliated with (if applicable). PSO Name/Contact:

Include national sport governing body team was affiliated with (if applicable). NSO Name/Contact:

Highest Level of Competition available at the time the team was competing:

International / World

National / Western Canada

Provincial

Part C: Community Connections

Detail how the team being nominated brought credit and high respect for the team or sport while based out of Lac La Biche County. Highlight the nominated team’s involvement within Lac La Biche County (volunteer work, mentoring, sport development, etc.)(Required)

Optional: Include pertinent newspaper clippings and/or letters of support with the nomination.

Drop files here or

Max. file size: 50 MB, Max. files: 10.

Part D:

Has this team been inducted into another recognized Local, Provincial, National, or International Sports Hall of Fame?

Yes

If yes, which one?(Required)

When?(Required)

Were any members of this team recognized for their performances in play-off, championship, or higher competitions during the tenure of the team’s nomination year(s)?

Yes

Examples: MVP most valuable player, All-star selection, other Hall of Fame or prestigious awards

If yes, please identify the player or team staff names and awards they received. Include photographs or clippings if available.(Required)

Team

Player Name

Competition

Date

Awards / Recognition Received

Did any team members go on to compete at a higher level of sport as an individual and/or team (e.g.) Professional sport, Olympics, etc.?(Required)

Yes

If yes, please include details.(Required)

Player Name

Sport

Level of Competition

Status / Records

Years Competed

Part E: Storyboard Bio of Team

In the space provided, in 500 words or less summarize the team’s achievements for their storyboard which is displayed on the Lac La Biche County Sports Hall of Fame. Highlight key accomplishments, awards, and chain of events with dates which led to their overall success and achievements. *Lac La Biche County may edit text for grammar, length, and consistency to create team story and will send final for review for approval prior to production.(Required)

Part F: Team Photo

Team Photo(Required)

Max. file size: 50 MB.

High resolution digital photo (1200 x 900 dpi) JPG or TIFF files preferred

If selected for the Lac La Biche County Sports Hall of Fame, Lac La Biche County will require a photo including all of the names of team members and staff in order portrayed in the photograph. Example: Back row (l-r), Front row (l-r), and so on. Include any individual’s names who are missing from the photograph below.

Drop files here or

Max. file size: 50 MB.