Sports wall of fame nomination

Posthumous nominee*

Yes

Nominee information

Full name/Team name

Place of birth

Current address

City/Town

Province

Postal Code

Country

Telephone(s)

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

Full name

Relationship to nominee

Address

City/Town

Province

Postal Code

Country

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:

Competitive sport(s) in which the Nominee excelled:
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

Choose file

One file only.
256 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

Contact information of person submitting the nomination

Full name

Address

City/Town

Province

Postal Code

Country

Telephone(s)

Fax