INDIANA BASKETBALL HALL OF FAME
GIRLS BASKETBALLNOMINATION FORM
PLEASE TYPE OR PRINT
1. Candidate’s Name ______
(Last Name)(First) (Middle) (Maiden) (Nickname)
2. Home Phone ______Work Phone ______E-Mail ______
3. Address ______
(Street)(City)(State)(Zip)
4. Birth______
(Date)(Place)(Date of Death)
5. High School ______
(Year of Graduation)(Name)(City & State)
6. High School Athletic Record (Please list team regular season and post-season record, by year; list individual scoring, rebounding, assist averages when available; summarize records and awards.)
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7. High School Coach: Name______
Address______
8. Colleges Attended: ______(Year) (Degree) (Field) (College)
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(Year) (Degree) (Field)(College)
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(Year) (Degree) (Field)(College)
9. Suggested category of nominee: Coach ______Player ______(please check one)
10. College Athletic Record (Please list team regular season and post-season record, by year; list individual scoring, rebounding,assist averages when available; summarize records and awards.)
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11. College Basketball Coach: Name ______
Address______
12. Basketball Achievements (since graduation from high school and/or college)______
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13. High School and College Extra-Curricular Activities:______
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14. Height in playing days ______ft. ______in.
15. Employment since graduation (list yrs.) (Coaches – please fill out year by year and your record at each school)
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16. Present Position: ______
Firm______
Address______
17. Military Service Record ______
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18. Sororities ______
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19. Clubs and Lodges ______
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20. Civic Organizations______
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21. Marital Status (Name of Spouse) ______
Home Town ______State ______
22. Children (List Names and Year of Birth) ______
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23. Hobbies ______
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IMPORTANT!
PLEASE ENCLOSE 2 CURRENT PHOTOS OF CANDIDATE,
AND AT LEAST ONE CANDIDOR ACTION PHOTO OF
CANDIDATE FROM PLAYING OR COACHING DAYS
(This page to be completed by High School, College, Organization, or Individual Submitting Application)
PLEASE TYPE OR PRINT
1. Individual or Organization ______
2. Address ______
(Street)(City) (State)(Zip)
3. Present Occupation ______
4. Athletic Affiliation ______
5. Supplemental Documentation:Please submit 2-5 clippings, programs, or other printed materials that document
some of therecords and achievements listedherein. Letters of recommendation from peers (maximum 3) are also
appropriate.
______(Signature of person making nomination) (Date)
(Note: If additional space is needed, please use plain sheet of white paper, 8½ × 11 inches, write on one side only, preferablytypewritten.)
Indiana Basketball Hall of Fame
Phone (765) 529-1891
Fax (765) 529-0273
Email:
NOMINATIONS DUE AUGUST 1 TO BE ELIGIBLE FOR FOLLOWING CALENDAR YEAR CONSIDERATION
(example: DUE AUGUST 1, 2011 FOR ELIGIBILITY 2012)
Return to:
Indiana Basketball Hall of Fame
Nominations Committee
One Hall of Fame Court
New Castle, IN47362