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Ray Lewis

Nomination Form

DISTINGUISHED SPORT VOLUNTEER

NOMINATION FORM

2010

INDIVIDUAL SPORTS AWARD

Nominee

Name of the Nominee

Address

Phone

E-Mail

Nominator

Name of the Nominator

Phone

E-Mail

Additional Information

Explain how this nominee has made a significant contribution and impact on amateur sport in the Hamilton and Region community

How many years of volunteer service has this nominee contributed to amateur sport?

What positions has this person held in sport?

Referee/Official (Years)

Coach (Years)

Assistant Coach (Years)

Club Administrator/Executive Member (Years)

Other (Years)

What specific accomplishments or achievements has this nominee had?

Outline any other information that may be of value in considering this nominee for any of the following awards

Volunteer of the year award
Ray Johnson Coach of the year award
Fair play award (official of the year)
Ray Lewis community service award
Sport hero banner series award
Gene Sutton memorial award

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