Nomination Form Honda Inspiration Award

CLASS of 201
8

NOMINATION FORM – HONDA INSPIRATION AWARD

Due no later than April 16, 2018

Full Name of Student-Athlete Nominated: ______

Sport: ______Institution:______

Hometown: ______Current Academic Year in School: ______

Date of Adversity: ______Year Returned to Competition: ______

Cell Phone: ______Home Phone:______

Email: ______

Nominator:______

Title of Nominator: ______

Office Phone: ______Cell Phone: ______

Email: ______

Date: ______

AWARD CRITERIA:

•A nominee must be, or must have been a woman student-athlete at a Division I, II, or III NCAA member institution and must be, or must have been, a member of an NCAA-sponsored varsity intercollegiate team during the current academic year.

•A nominee must have experienced serious physical and/or emotional adversity, injury and/or illness or experienced extraordinary personal sacrifice at the earliest during her senior year in high school or summer before college with a recovery during her collegiate years or anytime throughout her college career as a student-athlete

•A nominee must have participated in intercollegiate competition during the current academic year and earned individual honors and/or distinction for her outstanding intercollegiate athletic success. However, when nominee is a spring sport athlete and performance accomplishments not yet determined by nomination deadline, she can be nominated in the following year.

•If the adversity was medical in nature (injury, illness, or disease), a letter from the institution’s sports medicine director or physician is required.

•Institutions are limited to one nomination per academic year, and the institution’s Director of Athletics or Senior Woman Administrator must have approved and signed the nomination.

NOMINATION PROTOCOL:

1. Please fully describe the physical and/or emotional adversity, injury and/or illness experienced by the student-athlete, or extraordinary personal sacrifice that interrupted her intercollegiate competition.

2. Describe how she managed the adversity, was an inspiration to others, exemplified leadership, etc.

3. Describe the athletic honors or distinctions earned after she returned to competition.

Important Checklist of Items to be included with Nomination:

_____ Completed Nomination Form (required)

_____ Athletics honors or distinctions earned after nominee returned to competition (required)

_____ Signature of Director of Athletics or Senior Woman Administrator supporting nomination

and confirming that nominee is in good academic standing (required)

_____ If the adversity was medical (injury, illness, or disease), a letter from the institution’s

sports medicine director or physician is required as a supplement with the nomination.

(required)

_____ A personal statement from nominee. (required and limited to one page please)

_____ One media story about the nominee may be attached as a supplement. (Optional)

APPROVAL of NOMINATION and acknowledgement of good academic standing by Director of Athletics or Senior Women Administrator

Name ______

Signature ______

Position ______

Office Phone: ______Email:______

Nominations with required documents and supplements must be returned to with the nominee's name and school in the subject line and received no later than April 16, 2018.