NOMINATION FORM FOR SIDNEY COMMUNITY SCHOOLS

ATHLETIC HALL OF FAME

PLEASE PRINT OR TYPE

NOMINEE INFORMATION

NAME____________________________________________________(maiden/married)

            LAST              FIRST                         MIDDLE        NICKNAME             

ADDRESS ___________________________________________________________

                        STREET                      CITY               STATE            ZIP CODE

PHONE NUMBER ___________________________

IS NOMINEE A SIDNEY HS. GRADUATE? _________  IF YES, YEAR OF GRADUATION _______

Category Nominated

            Athlete   □                  

            Coach     □       

            Team     □          

            Athletic Contributor  □       Specify Reason:  ___________________________

             ____________________________________________________________________________________________

             __________________________________________________________________________________________________                                                            

Played/Coached:  ____________________________________________________________________________________

 __________________________________________________________________________________________________                           

 __________________________________________________________________________________________________

 __________________________________________________________________________________________________

Awards or Outstanding Accomplishments:  _________________________________________________________________

 __________________________________________________________________________________________________

 __________________________________________________________________________________________________

 __________________________________________________________________________________________________

Other Pertinent Information (which may assist the Hall of Fame Committee’s decision on the nominee for consideration into the Hall of Fame).  This may include newspaper clippings, photographs, yearbook articles, videos, etc.  Please submit or attach if possible.

 __________________________________________________________________________________________________

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Nominated by:  _______________________________________________

Address:  ____________________________________________________

City:  _______________  State:  _______________  Zip Code:  ________

Phone Number:  _______________________

If there are any questions or details you are unable to answer or provide, please leave blank and the Hall of Fame committee, school administration, past coaches or other knowledgeable persons will complete the questionnaire.

Please return nomination form to Sidney Community Schools; Attn:  Superintendent’s Office; 2754 Knox Road; P.O. Box 609, Sidney, Iowa  51652.

If you have questions, please call Sidney Community Schools:  (712)374-2731

Received by Hall of Fame Committee/Date:  ______________________________