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CCSHOF Nomination Form

First Name

Email

Sport or Position

Born in PA * Required

Yes

No

Retired from sport at least (3) years * Required

Yes

No

Over the age of 55 * Required

Yes

No

Last Name

Phone

Participant

Coach

Official

Contributor

Played in Centre County

Yes

No

Where in Centre County?

Been in sport or position (25) years * Required

Yes

No

Willing to attend Induction Ceremony * Required

Yes

No

Living * Required

Yes

No

Deceased for at least (1) year

Yes

No

Person ever convicted of a Felony * Required

Yes

No

Biographical Sketch of Nominee.

Thanks for you nomination! We look forward to reviewing the submission!

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