NominationpNomination form will not save. Please have all of your supporting documents and files ready before beginning the nomination process.Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.1Nominee Information2Nominee Profile3References4RequirementsNomination Category *AthleteBuilderCoachMastersOfficialPioneerSpecial AchievementTeamName *FirstLastAddress *Address Line 1Address Line 2City--- Select state ---British ColumbiaOntarioQuebecAlbertaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutPrince Edward IslandSaskatchewanYukonProvinceCode PostalLayoutPhone *Alternate PhoneEmail *LayoutDate of Birth *Place of Birth *LayoutYears Residing in Richmond:From *To *Layout (copy)If deceased, please provide date of deathDateNext of KinFirstLastCurrent AddressAddress Line 1Address Line 2City--- Select state ---British ColumbiaOntarioQuebecAlbertaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutPrince Edward IslandSaskatchewanYukonProvinceCode PostalLayoutPhone NumberEmailNominee or nominee’s next of kin consent *I consent to my nomination being submitted to the Richmond Sports Wall of Fame. I have reviewed the content within this nomination and declare it to be true and correct.ContinueTeam RosterTeam Members and Coaches (include individual information if available)Team RosterJersey No. *NameCurrent Address *Phone *Email *Team Roster row 2Jersey No. row 2 *Name row 2 *Current Address row 2 *Phone row 2 *Email row 2 *Team Roster row 3Jersey No. row 3Name row 3Current Address row 3Phone row 3Email row 3Team Roster row 4Jersey No. row 4Name row 4Current Address row 4Phone row 4Email row 4Team Roster row 5Jersey No. row 5Name row 5Current Address row 5Phone row 5Email row 5Team Roster row 6Jersey No. row 6Name row 6Current Address row 6Phone row 6Email row 6Team Roster row 7Jersey No. row 7Name row 7Current Address row 7Phone row 7Email row 7Team Roster row 8Jersey No. row 8Name row 8Current Address row 8Phone row 8Email row 8Team Roster row 9Jersey No. row 9Name row 9Current Address row 9Phone row 9Email row 9Team Roster row 10Jersey No. row 10Name row 10Current Address row 10Phone row 10Email row 10Team Roster row 11Jersey No. row 11Name row 11Current Address row 11Phone row 11Email row 11Team Roster row 12Jersey No. row 12Name row 12Current Address row 12Phone row 12Email row 12Team Roster row 13Jersey No. row 13Name row 13Current Address row 13Phone row 13Email row 13Team Roster row 14Jersey No. row 14Name row 14Current Address row 14Phone row 14Email row 14Team Roster row 15Jersey No. row 15Name row 15Current Address row 15Phone row 15Email row 15Team Roster row 16Jersey No. row 16Name row 16Current Address row 16Phone row 16Email row 16Team Roster row 17Jersey No. row 17Name row 17Current Address row 17Phone row 17Email row 17Team Roster row 18Jersey No. row 18Name row 18Current Address row 18Phone row 18Email row 18ProfileSport *Richmond Roots *Championships *Fun Fact *Contribution to Sport in RichmondBarriers Overcome *Career StatsContribution to Sports in RichmondCareer StatsYear or Year RangeTeam/OrganizationTeam/Organization/PositionHighlight (Games, Goals, Assists, Points)HighlightHighlight (Role, Position)Career Stats row 2Year or Year Range row 2Team/Organization row 2Highlight (Games, Goals, Assists, Points) row 2Career Stats row 3Year or Year Range row 3Team/Organization row 3Highlight (Games, Goals, Assists, Points) row 3Career Stats row 4Year or Year Range row 4Team/Organization row 4Highlight (Games, Goals, Assists, Points) row 4Career Stats row 5Year or Year Range row 5Team/Organization row 5Highlight (Games, Goals, Assists, Points) row 5Career Stats row 6Year or Year Range row 6Team/Organization row 6Highlight (Games, Goals, Assists, Points) row 6Career Stats row 7Year or Year Range row 7Team/Organization row 7Highlight (Games, Goals, Assists, Points) row 7Full ProfileLayoutPositionUniversity/CollegeLayoutWeightHeightLayoutRichmond OrganizationYears PlayingYears Playing or Involved in this SportYears CoachingYears OfficiatingLayoutOther Sports PlayedOther Sports Involved inOther SportsOther Sports Played or Involved inNicknameLayoutInspirationJersey NumberAll Awards (Hall of Fame, MVP, Recognitions)All AwardsYearAwardDescription (Team, Organization, Olympic Games, World Championship)All Awards row 2Year row 2Award row 2Description (Team, Organization, Olympic Games, World Championship) row 2All Awards row 3Year row 3Award row 3Description (Team, Organization, Olympic Games, World Championship) row 3All Awards row 4Year row 4Award row 4Description (Team, Organization, Olympic Games, World Championship) row 4Major Achievements (Championships)Major Achievements (Championships)YearAchievementDescription (Team, Organization, Olympic Games, World Championships)Major Achievements (Championships) row 2Year row 2Achievement row 2Description (Team, Organization, Olympic Games, World Championships) row 2Major Achievements (Championships) row 3Year row 3Achievement row 3Description (Team, Organization, Olympic Games, World Championships) row 3Major Achievements (Championships) row 4Year row 4Achievement row 4Description (Team, Organization, Olympic Games, World Championships) row 4Major Achievements (Championships) row 5Year row 5Achievement row 5Description (Team, Organization, Olympic Games, World Championships) row 5PhotosPlease enter file name, caption and credit for the uploaded photos.Photo 1File NameCaptionCreditPhoto 2File Name - photo 2Caption - photo 2Credit - photo 2Photo 3File Name - photo 3Caption - photo 3Credit - photo 3Photo 4File Name - photo 4Caption - photo 4Credit - photo 4Photo 5File Name - photo 5Caption - photo 5Credit - photo 5File Upload Click or drag files to this area to upload. You can upload up to 5 files. Please upload your photos here. Allowed file extensions: JPG, PNG, JPEG, and PDF, Max file size: 5MB, Max # of files: 5PreviousContinueReferencesReferences may be contacted to verify some or all of the information provided in this application. Minimum of one reference required.ReferencesName *Phone *Team/Organization *Relationship *Years Known *References row 2Name 2Phone row 2Team/Organization row 2Relationship row 2Years Known row 2References row 3Name 3Phone row 3Team/Organization row 3Relationship row 3Years Known row 3PreviousContinueNomination Package RequirementsPlease check the boxes to acknowledge each line below *Have completed all sections of the form. (Incomplete forms will be returned to the nominator.)Are aware that high resolution photo(s), video(s) of the nominee (preferably during competition) or memorabilia included may be used for publicity purposes if nominee is selected. Please provide a description of the photos including names of others appearing in the photo, year of the photo and who took the photo.Have provided a letter of reference from nominator.Have signed permission of Nominee or next of kin.Nomination will become exclusive property of the City of Richmond to be used and displayed as part of the Richmond Sports Wall of Fame. Nominations will be kept on file for three (3) years, after which time unsuccessful applications will be returned to the nominator. Additional photos, testimonials, newspaper clippings, copies of awards, pictures of significant trophies or medals and any other supporting documents are encouraged to be included in the submission. We encourage copies of photos, articles, etc., over the submission of original material.Nominator’s InformationName *FirstLastAddress *Address Line 1Address Line 2City--- Select state ---British ColumbiaOntarioQuebecAlbertaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutPrince Edward IslandSaskatchewanYukonProvinceCode PostalLayoutPhone *Alternate Phone: *Email *Letter of reference Click or drag a file to this area to upload. Please uploadyour letter of reference from nominator. Allowed file extensions: JPG, PNG, JPEG, and PDF, Max file size: 5MB, Max # of files: 5The nominator agreement *The nominator is agreeing that all information included in this application is accurate and timely to the best of their knowledge and that all nomination package requirements have been included. This nomination will be considered incomplete until the photo and all other information has been received. Upon submitting the nomination, all supporting documents, including photos, become property of the City of Richmond and the Richmond Sports Wall of Fame.If you have any questions, please contact sportswalloffame@richmond.ca or by phone at 604-244-1274.Submit