Nova Scotia Sport Hall of Fame Builder Nomination Form

Nova Scotia Sport Hall of Fame Builder Nomination Form

DEFINITION:

BUILDER - An individual who has made a major contribution to the

development and advancement of sport or sports provincially, nationally or internationally.

May include but not limited to:

Administrators, Officials, Technicians, Coaches, Educators, Organizers, Sponsors

ELIGIBILITY REQUIREMENTS:

Any person born in Nova Scotia or resided in Nova Scotia during

his/her accomplishments. A builder shall be eligible for election at anytime.

Please Note:

At any time during the process of putting together your nomination you have questions please contact:

Shane Mailman

Manager - Facility and Communications

(902)404-3339

NOVA SCOTIA SPORT HALL OF FAME BUILDER NOMINATION

PLEASE READ CAREFULLY

Deadline for nomination submission is January 31st every year

Must be submitted on 8 ½ by 11 white paper in 12 point font.

Use of the nomination form is mandatory. Nominations received in

non-standard format will be returned for re-submission.

One page covering letter from the nominator is acceptable.

List of accomplishments should be in chronological order or order of greatest/most relevant accomplishments.

Up to four one page letters of support/reference will be accepted. These should be from people who were associated with the sporting career of the nominee.

Verification of accomplishments is required. These may include newspaper articles, media, awards, certificates, etc. They must fit on no more that four pages.

Nominations can be stapled but no binding, scrapbooks, or covers.

 Please submit copies not originals.

Nominations must be typed.

No DVD’s, VHS, Audio Tapes.

Please include one picture if available.

Note that only 12 pages maximum will be forwarded to the Selection Panel and Committee.

BUILDER NOMINATION FORM

Nominee

NOMINATED FOR PARTICIPATING
IN THE FOLLOWING SPORT(S)
Full Name:
Last / First / Initial / Nickname
Address: / Apartment/Unit #
Prov / Postal Code
Home Phone: / () / Work
Phone: / ()
Date of Birth: (D/M/Y) / Place of Birth: / IF DECEASED PLEASE CHECK APPROPRIATE BOX AND INCL. DATE OF DEATH
YES NO DATE OF DEATH: (D/M/Y)
Next of kin: / (Please include even if very much alive)
Address: / Apartment/Unit #
Prov / Postal Code
Home Phone: / () / Work Phone: / ()

INFORMATION ABOUT NOMINATING PERSON OR GROUP

Name of the Person or Group Submitting the Nomination:
Address: / Apartment/Unit #
Prov / Postal Code
Home Phone: / () / Work Phone: / () / Email
Contact:
(If different from above) / Home Phone: / Work Phone:
I give permission to the Nova Scotia Sport Hall of Fame to use the information contained in this nomination for research purposes YES NO
I certify that the information I provide is accurate and true to the best of your knowledge
SIGNATURE OF NOMINATOR:

CAREER INFORMATION

Sports in which the Nominee was involved as a builder:
Primary
Sport: / Secondary Sport:
Period of Involvement:
Please Check what function best identifies the nominee’s contribution as a builder.
Administrator / Official / Technician / Coach / Educator
/ Organizer / Sponsor
/ Patron
For Office
Use Only: / Received By: / Date Received:

In the page below outline the major accomplishments of the Builder. This includes years of commitment, major accomplishment, awards, etc. Please use point form.(Two page maximum, 12 point font minimum)

PLEASE NOTE:

USE OF THE NOMINATION FORM OR FORMAT IS MANDATORY. NOMINATIONS RECEIVED

IN A NON-STANDARD FORMAT WILL BE RETURNED FOR RE-SUBMISSION