Nominations

NOMINEE INFORMATION

Name:

First

Last

Graduation Year:

Address:

Street AddressCityState / Province / RegionPostal / Zip Code

Phone:

Area Code

Phone Number

Cell:

Area Code

Phone Number

E-mail:

Sports Played:

Special Accomplishments/Honors (coach, contributor, adminstrator):

Years:

Summary of Qualifications (athletes):

NOMINATOR INFORMATION

Nominator Name:

First

Last

Nominator Phone:

Area Code

Phone Number

Nominator Cell:

Area Code

Phone Number

Nominator E-mail:*

Relationship to Nominee: