Athletic Hall Of Fame Nomination Application

Nominee Information:

Name of Nominee(required)

Nominee Email:(required)

Nominee Address (Street):

Nominee Address (City):

Nominee Address (State):

Nominee Address (Zip):

Nominee Home Phone:(required)

Nominee Cell Phone:

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

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:(required)

Nominated by Address (Street):

Nominated by Address (City):

Nominated by Address (State):

Nominated by Address (Zip):

Nominated by Phone:(required)

Nominated by Email:(required)

Date:(required)