Auburn Lewiston Sports Hall of Fame Nomination Form
RequiredRequired Question(s)
1.
Please enter the information indicated below of the person you are nominating.

First Name:
Last Name:
Work Phone:
Home Phone:
Email Address:
emailaddress@xyz.com
Address 1:
Address 2:
City:
State/Province
(US/Canada):
Postal Code:

2.

Date of birth 

 

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3.

Place of birth 

 

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4.

(if deceased) Date of death & location 

 

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5.

High School, Graduation Year & Location 

 

350 characters left.
6.

Prep School, Graduation Year & Location 

 

350 characters left.
7.

Colleges Attended (1)

 

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8.

Location (1) 

 

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9.

Years attended (1)

 

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10.

Degree (1) 

 

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11.

Year graduated (1)

 

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12.

Colleges Attended (2)

 

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13.

Location (2) 

 

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14.

Years attended (2)

 

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15.

Degree (2) 

 

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16.

Year graduated (2)

 

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17.

Colleges Attended (3)

 

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18.

Location (3) 

 

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19.

Years attended (3)

 

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20.

Degree (3) 

 

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21.

Year graduated (3)

 

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Required 22.
Sports Record: Please use space below to indicate participation in sports, years played and special honors or recognition. You are encouraged to submit photographs, news clippings, programs, articles or other information you feel will be helpful to the selection committee. A recent head and shoulders photograph will be required for persons selected for honors.
 

1000 characters left.
23.

Employment History (include elected or appointed public service) 

 

1000 characters left.
24.

Civic Activities (participation in civic, professional, religious, fraternal, veterans organizations associations or activities.  Include honors or awards received and positions held.)   

 

1000 characters left.
25.

Other (list any other information which you feel may be helpful to the selection committee) 

 

1000 characters left.
26.

Who can we contact for additional information? 

 

350 characters left.
Required 27.

This application was filled out by... please give us your name, address, email and telephone number.  

 

350 characters left.