While nominations are accepted year-round, the deadline for consideration for the Class of 2017 is August 31, 2016.  So, please do hurry along!

Official Nomination Form

Kentucky Athletic Hall of Fame

    A copy of this form should be completed on behalf of each nominee for induction into the Kentucky Athletic Hall of Fame. A summary narrative and additional information (news clippings, testimonials, support letters, action photos, etc.) should be attached whenever possible. Please type or print clearly!

      I hereby nominate the following person for the Kentucky Athletic Hall of Fame’s Class of 2017:

NOMINEE'S FULL NAME: _______________________________________________________  DATE _____________
                                                First              Middle        "Nickname"            Last

DATE OF NOMINEE'S BIRTH: ______________________________________     Is nominee deceased?     Yes     No

NOMINEE'S HOME ADDRESS ________________________________________________________________________

                                                              City                                                 State                          ZIP Code

HOME PHONE (        ) __________________________ WORK PHONE (          ) ______________________________

 

SPORT(S) _________________________________________________________________________________________

                               High School                         College                    Professional                  Other

 

CAPACITY OF CANDIDATE SPORTS INVOLVEMENT __________________________ WHAT YEARS?_____________
(Player/Coach/Official/Administrator)

                                                              Can you assist in contacting the candidate?     Yes         No

RÉSUMÉ - If possible, please attach résumé listing sports accomplishments.

DOCUMENTATION - Résumé is best accompanied by documentation such as newspaper articles, school or organization records, action photos, etc. Scrapbooks are acceptable, but call first at 502-637-7696.

Nomination and questionnaire submitted by:

NAME

______________________________________________

ADDRESS

______________________________________________

PHONE (H)

______________________________________________

PHONE (W)

______________________________________________

I attest that the information presented in this document, to be the best of my knowledge, is true.

_______________________________________________

 

_____________________

(Nominator's  Signature)

 

(Date)

While you may elect to email this completed form to us (vweber@kosair.org  or ssmith@kosair.org), to provide fuller support for your nomination all in one complete package, you may prefer to print out this form and then mail it, along with résumé, action photos and supporting documents, to:

Kosair Charities

Attn: Kentucky Athletic Hall of Fame
P.O. Box 37370 
Louisville, KY 40233

While nominations are accepted year-round,
the deadline for consideration for
the Class of 2017 is
August 31, 2016
So, please don't delay!