Distinguished Sport Volunteer Nomination Form

Step 1.

Name of nominee	*
Address	*
Phone	*
Email	*

Step 2.

Name of Nominator	*
Phone	*
Email	*

Step 3.

Explain how this nominee has made a significant contribution and impact on amateur sport in the Hamilton and Region community. *

Step 4.

How many years of volunteer service has this nominee contributed to amateur sport? A minimum of 10 years is required to be considered for this award. *

Step 5.

What positions has this person held in sport?

Referee/Official
Years

Coache
Years

Assistant Coach
Years

Club Administrator/Executive Member
Years

Other

Step 6.

What specific accomplishments or achievements has this nominee had? *

Step 7.

Outline any other information that may be of value in considering this nominee for any of the following awards. ( NOTE: See criteria for each award in order to qualify for this nomination under awards) Please check off only one award per person. VOLUNTEER OF THE YEAR AWARD RAY JOHNSON COACH OF THE YEAR AWARD FAIR PLAY AWARD (OFFICIAL OF THE YEAR) RAY LEWIS COMMUNITY SERVICE AWARD SPORT HERO BANNER SERIES AWARD

ALL ENTRIES MUST BE COMPLETED AND SUBMITTED NO LATER THAN:
MIDNIGHT SUNDAY JULY 30^TH 2011 FOR CONSIDERATION.

ALL AWARD WINNERS WILL BE NOTIFIED AND MUST CONFIRM ATTENDANCE TO THE AWARDS DINNER.

Sport Hamilton Breakfast of Champions Medallion

Are you a Provincial, Regional,
National or International Champion from 2013

If you are, Register for the December 2, 2013
Annual Breakfast of Champions to be held at
Carmen's Banquet Centre

Deadline for all registrations is Friday, November 8, 2013
11:59 pm

KEEP TRACK OF POST SECONDARY
ATHLETICS:

McMaster
Mohawk
Redeemer