NLAA
Hall of Fame

Nomination Form

Personal Information
Date:   Category: Athlete:   Builder:   Official/Coach:
Nominee´s Name:
Nominee´s Address:
City/Town   Province   Postal Code 
Telephone: Area Code     -  Work     -  Home
Date of Birth:   Place of Birth: 
If Deceased, Date of Death:
Sport: (In Order of Importance) Cross Country Running, Road Running, Track and Field
  1.  
  2.  
  3.  

 
Next of Kin
Name: 
Address of Kin: 
City/Town   Province   Postal Code 
Telephone of Kin: Area Code     -  Work     -  Home

 
Nominator
Name of Nominator:
Address of Nominator:
City/Town   Province   Postal Code 
Telephone: Area Code     -  Work     -  Home
Date of Nomination:   Signature 

 

Participation as an Athlete Category

List the details of the nominee´s competitive career as an athlete, including names of championships attained, medals won, records and awards achieved. Complete under the headings:

  1. International Competition (Olympics, etc)

     
  2. National Competition

     
  3. Atlantic Competition

     
  4. Provincial Competition

     

Participation as a Builder/Official/Coach Category

Give complete details of nominee´s involvement in cross country running, road running and track and field.


  Print this form

Mail the completed Nomination form to:

THE NEWFOUNDLAND AND LABRADOR
ATHLETICS ASSOCIATION
P.O. Box 3202
Paradise NL A1L 3W4

NOMINATIONS MUST BE RECEIVED AT THE ABOVE ADDRESS ON OR BEFORE MARCH 31 OF THE YEAR IN QUESTION.