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NOMINATION FORM:  (2 pages will download)

Nominee name:_____________________________________________________________

Address:___________________________________________________________________________________________

Phone:__________________    Cel:___________________       E-mail:_________________________

Category:   (______ Athlete)     (______ Coach)     (______ Builder)    (______ Team)

Sport(s):________________________________________________________

List Accomplishments in this area in descending order: (Attach supporting documents)  

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 How did you hear about the Burnaby Sports Hall of Fame? ___________________________

Nominated by:____________________________________________________

Address:__________________________________________________________________

_________________________________________________________________________

Phone:_____________________________   Cell:_________________________    E-mail:____________________________

Signature:____________________________________       Date:_________________________

Send Nomination Form to:
Nomination, Jill Porter
Burnaby Parks, Recreation and Cultural Services,
#101 - 4946 Canada Way,
Burnaby, B. C. V5G 4H7

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