Nominator Information:
(Items beginning with a * are required for form to be accepted)
*Name:     
*Address:     *City:     *State:     *Zipcode:
*Email:          Cell Phone:     Home Phone:
Nominee Information:
(Items beginning with a * are required for form to be accepted)
Note: For Team Recognition enter Sport for First Name and Year that school year began as Last Name (Ex: Football,Swimming, Baseball for 1999-2000 school year would all be 1999). Ignore address, email, and phone.
*First Name:       *Last Name:       CHECK this box if Nominee is known to be deceased:  
*Address:     *City:     *State:     *Zipcode:
*Email:          Cell Phone:     Home Phone:
Nominating Category (Check ALL that apply):
  Student Athlete
  Coach
  Contributer
  Team Recognition

Basis for Nomination:
Please provide accurate information that will substantiate the basis for the nomination in one or more of the categories listed below. Be specific with regard to any awards or honors including the year the award was bestowed and the awarding entity
Student-Athlete Achievements (e.g., All-State, LCAA All Star, Section Championship All Tournament/MVP, Record Holder):

Coaching Record/Achievements (e.g., Overall win/loss record, championships, coach of the year):

Contributor (nature of contribution, e.g. - statistician, field maintenance, administrator, outstanding community support):

Team Recognition (e.g., State Champion, State Championship finalist/qualifier, Section V Champion, LCAA League Champion):
Name of TEAM being Nominated:   

TEAM Accomplishments:
Other Pertinent Information (Please feel free to include any other information you feel is pertinent to the nominee’s candidacy including, but not limited to, academic achievements/performance, community and/or professional service activities, sportsmanship):



--- IMPORTANT INFORMATION FOR ALL ---

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