Newmarket Sports Hall of Fame Inductee Nomination Form

Contact Information:
Please provide the following information to allow the committee to contact you for
further information, as required:
Date Submitted: _________________________________________________________
Name: _________________________________________________________________
Address: _______________________________________________________________
City/Prov./Postal Code: ___________________________________________________
Telephone: (Home) _______________________ Business: _____________________
E-mail: ________________________________________________________________
Signature:
_______________________________________________________________________
References:
For the purposes of compiling information on the Nominee to assist the Selection
Committee in judging, we requests three (3) references (at least one being from a non
family member).
Name: _______________________________ Telephone: _______________________
Address: _______________________________________________________________
Name: _______________________________ Telephone: _______________________
Address: _______________________________________________________________
Name: _______________________________ Telephone: _______________________
Address: _______________________________________________________________
Note: Please feel free to attach additional paper if required.