APPLICATION FOR NAMING A GEOGRAPHICAL FEATURE Return to: Coordinator, Geographical Names Program Historic Resources Management 8820 – 112 Street, Edmonton, Alberta T6G 2P8 Phone: 780-431-2334 Fax: 780-427-5598 e-mail: Ronald.Kelland@gov.ab.ca Note: All Requested Information Must Be Provided If Relevant to the Application Proposed Name: Feature Type: Location: Notes: - For linear features (creeks, rivers, etc.) the location should be where the feature enters a larger body of water (lake or another creek/river) or crosses a provincial boundary) For features such as lakes, mountains, hills, etc. The location should be close to the middle of the feature or at the highest point of elevation) ATS: LSD ¼ Sec Twp Latitude: ° ' " N Longitude: ° ' " W Rge W Municipality: Description: (Ex., Altitude, Size/Area, Direction of flow, Length, Relation to/Distance from other features or communities) What is the origin or meaning of the proposed name? If the proposed name is commemorative in nature, is the person(s) deceased? Yes No Date of death: If the proposed name commemorates an event, when did the event occur? Click here to enter text. If the proposed name is commemorative, provide biographical and/or chronological details and explain how the person(s) or event has had a significant impact on the feature or region and/or has contributed to the cultural legacy of the Province of Alberta. If being named for a person(s), is the family supportive of this proposal? Yes No Not aware of any family or descendents If family or descendents can they be contacted by Geographical Names Program staff, please provide their contact information. If the proposed name is already in well-established use, provide details about how long the name has been in use and what evidence is available to substantiate its use. Is this feature known by any other names (Official, Local, Historical or Aboriginal/Indigenous)? If so, please list those names and provide any details that are known. If there are any other reasons for this naming proposal, or if there are any additional details or information not covered by the above questions, please include them below. Please provide the contact information of at least five other people who are supportive of this naming proposal or who may be able to provide additional information about the proposed name. 1. Name: Address: Telephone #: e-mail: # of years in the area: 2. Name: Address: Telephone #: e-mail: # of years in the area: 3. Name: Address: Telephone #: e-mail: # of years in the area: 4. Name: Address: Telephone #: e-mail: # of years in the area: 5. Name: Address: Telephone #: e-mail: # of years in the area: Applicant/Proponent Information Name: Address: Telephone #: e-mail: Relationship to person or event being commemorated or connection to the proposed name: Signature of Applicant: Date: _________________ Please attach or forward to the Alberta Geographical Names Program the following: A copy of a National Topographic System (NTS) 1:50,000 Map Sheet indicating the location and extent of the feature to be name. At least one unmarked photograph of the feature (the date and approximate location the photograph was taken, and a description if necessary, should be written on the back of the photograph – Please do not write or mark the photograph itself) A Historic/Archival photograph of the feature (if available). If the proposed name is commemorative in nature, a photograph of the subject being commemorated. Copies of any petitions, letters, etc. Demonstrating local support for the proposed name.