Athletic Hall Of Fame Nomination Application

Nominee Information:

Name of Nominee

Nominee Email:

Nominee Address (Street):

Nominee Address (City):

Nominee Address (State):

Nominee Address (Zip):

Nominee Home Phone:

Nominee Cell Phone:

Please List for each (Sport / Position / Number of Years / Coach):

High School Special Honors (Captains, All Ohio, State Champion, etc.):

Name of College:

Class:

Sports Played:

College Special Honors (Captains, All Ohio, State Champion, etc.):

Additional Information (current status, occupation, etc.):

Nominated by:

Nominated by Name:

Nominated by Address (Street):

Nominated by Address (City):

Nominated by Address (State):

Nominated by Address (Zip):

Nominated by Phone:

Nominated by Email:

Date: (YYYY-MM-DD)