UVIC SPORTS HALL OF FAME NOMINATION FORM
Vikes Athletics and Recreation
Student Affairs | University of Victoria PO Box 1700 STN CSC Victoria BC Canada V8W 2Y2 Phone: 250-721-8409 Fax: 250-721-8956 Web: www.uvic.ca/vikes
UVIC SPORTS HALL OF FAME NOMINATION FORM
NOMINEE INFORMATION FULL NAME:
DATE SUBMITTED:
YEARS AT UVIC:
YEARS WITH THE VIKES: SPORT:
DEGREE(S): ADDRESS:
CITY:
PROVINCE:
PHONE: (HOME)
(CELL)
EMAIL:
CATEGORY:
ATHLETE
TEAM
COACH
POSTAL CODE:
BUILDER/ADMINISTRATOR
1. Describe highlights of the nominee’s career at UVic and any other information useful to the Nomination Committee ATHLETE/NOMINEE BACKGROUND
RELEVANT ACHIEVEMENTS, AWARDS, RECORDS, STATS, ETC.
OTHER ACCOMPLISHMENTS
|1
Vikes Athletics and Recreation
Student Affairs | University of Victoria PO Box 1700 STN CSC Victoria BC Canada V8W 2Y2 Phone: 250-721-8409 Fax: 250-721-8956 Web: www.uvic.ca/vikes
UVIC SPORTS HALL OF FAME NOMINATION FORM
2. Provide a summary of the nominee’s accomplishments as a/with the Vikes as well as accomplishments since leaving UVIC.
3. Name and contact information for others who would speak about nominee’s accomplishments.
4. Please attach any relevant content for this submission such as newspaper articles, reference letters, photos, etc.
NOMINATOR INFORMATION FULL NAME: ADDRESS:
CITY:
PROVINCE:
PHONE: (HOME)
(CELL)
EMAIL:
POSTAL CODE:
RELATION TO NOMINEE
SUBMISSION INSTRUCTIONS Please submit to David Conlin, Communications Officer by email: [email protected] OR
by mail: A245 CARSA PO Box 1700 STN CSC Victoria BC V8W 2Y2 |2
Student Affairs | University of Victoria PO Box 1700 STN CSC Victoria BC Canada V8W 2Y2 Phone: 250-721-8409 Fax: 250-721-8956 Web: www.uvic.ca/vikes
UVIC SPORTS HALL OF FAME NOMINATION FORM
NOMINEE INFORMATION FULL NAME:
DATE SUBMITTED:
YEARS AT UVIC:
YEARS WITH THE VIKES: SPORT:
DEGREE(S): ADDRESS:
CITY:
PROVINCE:
PHONE: (HOME)
(CELL)
EMAIL:
CATEGORY:
ATHLETE
TEAM
COACH
POSTAL CODE:
BUILDER/ADMINISTRATOR
1. Describe highlights of the nominee’s career at UVic and any other information useful to the Nomination Committee ATHLETE/NOMINEE BACKGROUND
RELEVANT ACHIEVEMENTS, AWARDS, RECORDS, STATS, ETC.
OTHER ACCOMPLISHMENTS
|1
Vikes Athletics and Recreation
Student Affairs | University of Victoria PO Box 1700 STN CSC Victoria BC Canada V8W 2Y2 Phone: 250-721-8409 Fax: 250-721-8956 Web: www.uvic.ca/vikes
UVIC SPORTS HALL OF FAME NOMINATION FORM
2. Provide a summary of the nominee’s accomplishments as a/with the Vikes as well as accomplishments since leaving UVIC.
3. Name and contact information for others who would speak about nominee’s accomplishments.
4. Please attach any relevant content for this submission such as newspaper articles, reference letters, photos, etc.
NOMINATOR INFORMATION FULL NAME: ADDRESS:
CITY:
PROVINCE:
PHONE: (HOME)
(CELL)
EMAIL:
POSTAL CODE:
RELATION TO NOMINEE
SUBMISSION INSTRUCTIONS Please submit to David Conlin, Communications Officer by email: [email protected] OR
by mail: A245 CARSA PO Box 1700 STN CSC Victoria BC V8W 2Y2 |2
