Section A: Personal Information

1. (a) Nominees Name in full: ______Nickname if any: ______Current Address: ______Telephone: ______

1. b) Complete only if deceased: ______Date of Death: ______Next of Kin: ______Relationship: ______Address: ______Telephone: ______

2. Place of Birth: ______Date of Birth: ______Country of Citizenship: ______

Age Restriction: Individuals must be at least forty (40) years of age to be nominated or elected; provided however, that the age requirement can be waived by Committee if an individual is deceased or if as a result of a career-ending injury, the individual has been retired for at least five (5) years.

3. Educational Background: ______

4. Present or most recent Occupation: ______

5. Club Affiliations: Club Name Professional or Amateur Years: From - To ______

6. Please check below the role in which the Nominee has been most outstanding: Amateur Golfer: : Golf Administrator: Course Design/Management: Other, Please indicate: ______

Definitions: Amateur or Professional Golfer: Shall be a person who has an outstanding record in competitive golf at the national and/ or international level. Administrator: Shall be a person whose career has had a major impact on the growth and future direction of the sport of golf on the national and/or international level. Course Design/Management: Shall be a person who has had an illustrious career in golf course design, the management of golf facilities, or the maintenance of golf facilities in . Other: Shall be a person who has made an exceptional contribution to promoting the sport of golf and may include journalists, financiers, inventors, etc, on a national and/or international level. Section B: Major Achievements in the Sport of Golf

Please list the Nominee’s golf related achievments in chronological order. If more space is required, please attach an additional sheet.

ACHIEVEMENT YEAR

NATIONAL: ______

INTERNATIONAL: ______Section C: Listing of Awards and Recognitions

Please list all golf related awards, including admission to Provincial Hall(s) of Fame. Prestigious awards unrelated to golf may also be included here.

NATURE OF REWARD RECOGNITION YEAR

______

Section D: Significant Circumstances

1. Difficulty in achieving successes. If there is an uncommon commitment or perseverance required to overcome unusual or difficult circumstances, please describe this.

______

2. Contribution over time. If the Nominee has made a significant commitment to the sport over a long period of time please illustrate this. List the number of years with positions held, etc.

______

3. Other significant items. This is an optional space which may be used to provide other supporting information which lends further significance to the Nominee’s achievement.

______Section E: The Nominator

1. Name: Person/Association ______If Association, give contact name: ______Title: ______Telephone: ______Email Address: ______Address: ______

2. Relationship to the Nominee: ______Are/were you personally acquainted with the Nominee?: Yes ______No ______

3. Declaration of Authenticity: ______

I declare that to the best of my knowledge all of the information provided on this nomination for is accurate and correct:

Nominators Signature: ______Date: ______

4. Seconding the Nomination.

I declare that to the best of my knowledge all of the information provided on this nomination for is accurate and correct:

Nominators Signature: ______Date: ______Name (Please Print): ______Organization (If Relevant): ______Title: ______Phone Number(s): ______

5. Enclosures:

Required: A Nomination form completed in all respects.

A black & white or colour photograph of the nominee. ( 5x7 or 8x10 )

Optional: Copies or letters; clipping; certificates or other material which will support the significance of eth nominee’s achievement.

All such documentation is non-returnable and remains the property of the CGHF.

Note: Please feel free to use extra paper if you feel that space is limited.

SPACE BELOW IS FOR OFFICE USE ONLY Date Received: Complete: Photographs: Honoured Members

Keith Alexander 1986 George Knudson, C.M 1986 Marlene Stewart Streit, O.C. 1971 Stephen Ames 2014 Willie Lamb 1985 Violet Pooley Sweeny 1998 Al Balding 1985 Mary Ann Hayward 2007 Warren Sye 2016 James Barclay 2008 1972 Gordon B. Taylor 1986 Dave Barr 2000 George S. Lyon 1971 Stanley Thompson 1980 David Black 1972 Arthur Macan 2018 Mabel Gordon Thomson 1986 Ken Black 1987 1971 Margaret Todd 1997 Gayle Borthwich 1997 Henry Martell 1982 Murray Tucker 1999 , C.M. 1996 Fritz R. Martin 1974 Bob Vokey 2017 Gordon Brydson 1982 Rod McIssac 1983 Lisa Walters 2008 Donald Day Carrick, O.B.E 1997 Jack McLaughlin 2013 Bob Weeks 2016 Dawn Coe-Jones 2002 Gail Harvey Moore 1998 Mike Weir, C.M., O.M. 2009 Graham Cooke 2010 Alison Murdoch 2013 Nick Weslock 1972 Geoffrey Cornish 1996 Albert Murray 1974 Gordon Witteveen 2012 1972 Charles Murray 1971 Bob Wylie 1995 Gary Cumming 1971 Jim Nelford 2013 Richard Zokol 2011 Marion Doherty 1981 1995 Judy Darling Evans 2017 1995 Phil Farley 1979 Marilyn O’Connor 1999 Pat Fletcher 1976 Herb Page 2019 Bruce Forbes 1987 Bob Panasik 2005 Brent Franklin 2010 Claude Pattemore 1996 Alexa Stirling Fraser 1986 , C.M. 1988 Gail Graham 2018 Ralph H. Reville 1986 Richard Grimm 1993 Stephen Ross 2011 Dan Halldorson 2002 Doug Roxburgh 1990 Florence Harvey 1972 Lorne Rubenstein 2007 Wilf Homenuik 2005 Cathy Sherk 1995 Dorothy Campbell Hurd Howe 1991 Doug Silverberg 1989 Jules Huot 1977 C. Ross (Sandy) Somerville 1971 2016 Rod Spittle 2019 Karl Keffer 1986 Betty Stanhope-Cole 1991 Ben Kern 2010 John B.Steel 1988

CANADIAN GOLF HALL OF FAME, CELEBRATING THE GAME, ROYAL CANADIAN GOLF ASSOCIATION, RCGA, , and RCGA & Design marks are trademarks of the Royal Canadian Golf Association/Golf Canada