Shen Hof Nomination Form

Christopher Culnan Director of Athletics and Physical Education Shenendehowa High School 970 Route 146 Clifton Park, NY 12065

Date: ________________________ Nominee can be a former student-athlete, a coach, a contributor or a team* (*Teams eligible starting in 2011)

Nominee’s Name:

_________________________________________________ (Last)

(First)

(M)

Graduating Class:

_________________________________________________

Address:

_________________________________________________

Phone Number:

_______________ E-Mail Address: ____________________

Nominated By: Phone Number:

________________________________________________________ (Last) (First) (M) _____________________ E-Mail Address: _____________________

Role of person making nomination (circle one): Staff

Coach

Parent

Community Member

Other ____________

Please elaborate below why you feel this nominee should be inducted. Feel free to write about accomplishments, contributions, or any other facet of their athletic career at Shenendehowa. Should you need more space, please continue on the back or attach a separate sheet. Nominations must be returned by May 15th.

Team(s) Nominee Played for/Coached: ___________________________________________ Awards Received by Nominee:

____________________________________________

___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ ___________________________________________________________________________ Please submit to:

Shenendehowa Hall of Fame c/o Chris Culnan, Director of Athletics and Physical Education Shenendehowa High School 970 Route 146 Clifton Park, NY 12065 e-mail: [email protected]