Form

THE ALPINE CLUB OF CANADA

&

THE ASSOCIATION OF CANADIAN MOUNTAIN GUIDES

KARL NAGY

MEMORIAL AWARD

This is the only form which can be used when applying for the Karl Nagy Award. If your application is not fully completed it will be returned for completion to ensure our volunteer committee can properly assess all applications. Once you begin filling out this form your data will be saved at this url for ONE WEEK. Bookmark this page and return to it anytime within ONE WEEK to complete the form.

Please note the Selection Committee strongly prefers receiving applications in electronic format.

Years ending in an even number are designated for an ACMG aspirant guide; and years ending in an odd number are designated for an ACC volunteer.

Full Name *

First Name Last Name

Date of Birth *

- Month - Day Year

Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number *

- Area Code Phone Number

E-mail *

ACC Membership Number *

Describe your climbing, skiing and mountaineering background (please include details of any contributions that you have made to Canadian mountaineering). *

Describe your involvement with the ACC and/or ACMG to date (please include details of any volunteering you have done). *

Why are you applying for this award? *

What are your future outdoors goals? *

What are your future career goals? *

How will this opportunity assist in meeting your future outdoor/career goals? *

Do you have any other related information you would like to provide to the selection committee?

Please provide two letters recommending you for this award. These letters may be attached below or be sent to adventures@alpineclubofcanada.ca directly from your references.

Letter #1

Letter #2

BY CLICKING 'SUBMIT' I CONFIRM THAT, TO THE BEST OF MY KNOWLEDGE, ALL INFORMATION IN THIS APPLICATION IS ACCURATE.

THE ALPINE CLUB OF CANADA

MEMORIAL AWARD

APPLICATION FORM