Athlete Information

* 1. Athlete First Name

* 2. Athlete Last Name

3. Athlete E-mail (if known)

4. Athlete Phone (if known)

* 5. Athlete Age

* 6. Athlete is a resident of the fifty (50) United States, including the District of Columbia and Puerto Rico who are at least thirteen (13) years old at the time of entry

Yes

* 7. Athlete Sport(s)

ArcheryBocciaCyclingGoalballPara PowerliftingParatriathlonShooting/Air RifleSitting VolleyballSwimmingTable TennisTennisTrack and FieldWheelchair BasketballWheelchair FootballOther

Nominator Information

* 8. First Name of Nominator

* 9. Last Name of Nominator

* 10. Nominator E-mail

* 11. Nominator Phone

* 12. Relationship of Nominator to Athlete

* 13. How does the nominee lend support and encouragement to others to achieve their greatest potential?

* 14. How does the nominee serve as a role model within the adaptive sports community?

* 15. Provide multiple examples of how the nominee exhibits commitment, persistence, and/or discipline to their sport.