Nominee information – Étape 1 de 8Select the nature of the applicationInternation athleteNational athleteProvincial athleteDiscovery athleteGreetingsSirMadamMissLast nameFirst nameDate of birthAdressCityPostal codeAreaCollines-de-l'OutaouaisGatineauPapineauPontiacVallée-de-la-GatineauE-mailPhone numberGenderFemaleMaleNextLast nameFirst nameE-mailRelation to the athletePhone numberPreviousNextWhat sport is practisedWhat year did the applicant start practising their sportIs the applicant a member of a national team?YesNoIs the applicant a member of a provincial team? In the province of Québec?YesNoAt which level does their respective sports federation acknowledge them at?NoneSport studiesAspirationSuccessionEliteExcellencePreviousNextComplete in order from the most to the least significant event from the past year.EVENT #1Name of the eventDate of the eventLocation of the eventCompetition levelInternationalNationalProvincialRegionalRankingNumber of competitorsWhy is this achievement the most significant from the year?EVENT #2Name of the eventDate of the eventLocation of the eventCompetition levelInternationalNationalProvincialRegionalRankingNumber of competitorsWhy is this achievement the most significant from the year?EVENT #3Name of the eventDate of the eventLocation of the eventCompetition levelInternationalNationalProvincialRegionalRankingNumber of competitorsWhy is this achievement the most significant from the year?PreviousNextWhy does this athlete deserve the recognition.Is the athlete involved in different causes? SpecifyDescribe the athlete’s performance improvements over the past year. PreviousNextMaximum of two attachments, such as a letter of support, press review, etc.Attachment #1Attachment #2Photo of the athlete in actionPreviousNextShould this applicant receive one of the scholarships, I agree to forward their social insurance number within two weeks of the gala.Bourse *J’acceptePreviousNextI declare that, to the best of my knowledge, the information provided in this form is accurate. I agree that all information I have provided in this form, may be forwarded to the appropriate parties, for the purpose of analyzing the application. I further acknowledge that I am responsible for notifying the candidate that I have nominated them, along with the date that the gala excellence sportive Outaouais will take place.Déclaration *I acceptPreviousEmailSubmit application