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Canadian Petroleum Hall of Fame Nomination Form

 

The Purpose
To recognize, document, preserve, and publicize the names and deeds of those persons, both alive and deceased, whose contributions to the advancement of the Canadian Petroleum Industry have been of superior benefit to the nation.

 

Criteria
Nominees for the Canadian Petroleum Hall of Fame shall be restricted to those persons whose
outstanding achievements and contributions have been of major benefit to Canada and the Canadian petroleum industry, and have stood the test of time.

 

Download Nomination Form PDFIf you prefer to print out the form and mail the application, please click the button on the left for the PDF. Otherwise fill out the online form below.

 


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Nomination Form
Name of Nominee:
Current Address:
City, Province & Postal Code:
Phone Number:
Email:
Place & Date of Birth:

If Nominee is Deceased:
Place & Date of Death:

Name, Relationship &

Address of Next of Kin:

Industry Sector of Nominee:
Nominators and nominees should be aware that a nomination does not guarantee election to the Hall of Fame.
Nominated By:
Name:
Address:
Phone Number:
Email:
Date:
Seconded By:
Name:
Address:
Phone Number:
Email:
Date:

 

   
Copyright © 2010 Canadian Petroleum Hall of Fame. All Rights Reserved.