Ronald W. Plassman Gold Standard Award Nomination Form

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* 1. Nominee Contact Information

Name

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

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* 2. Category of Person Nominated

Athlete

Coach

Program Supporter

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* 3. Describe the gold standard values of sportsmanship and leadership lived out by the nominee (500 words or less)

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* 4. Describe how the nominee has significantly contributed to the betterment of the sport of goalball (500 words or less)

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* 5. Describe how the nominee has championed the sport of goalball and/or the Paralympic Movement through education and awareness (500 words or less)

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* 6. Attach any documentation in support of nominee (honors, awards, media clippings, etc.)

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.

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* 7. Contact information for person submitting nomination

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number