NATIONAL FOOTBALL FOUNDATION AND COLLEGE HALL OF FAME
SCHOLAR-ATHLETE NOMINATION FORM(Please Type or Print)
Name of Student / Jersey Number
Home Address
City / Zip / Phone
Parents' Names
Name of School / Address
City / Zip / Classification / Phone
FOOTBALL ABILITY: (40%)
Offensive Position
Defensive Position
Check any of the following that apply:
Senior Year - All-State - 1st Team / 2nd Team / HM / Position/s
Senior Year - All-Conference - 1st Team / 2nd Team/HM / Position/s
Senior Year - Super 25 - 1st Team / 2nd Team / 3rd Team / Position/s
Junior Year - All-State - 1st Team / 2nd Team / HM / Position/s
Junior Year - All-Conference - 1st Team / 2nd Team/HM / Position/s
Junior Year - Super 25 - 1st Team / 2nd Team / 3rd Team / Position/s
Soph. Year - All-State - 1st Team / 2nd Team / HM / Position/s
Soph. Year - All-Conference - 1st Team / 2nd Team/HM / Position/s
Soph. Year - Super 25 - 1st Team / 2nd Team / 3rd /HM Team / Position/s
Team Captain - Senior / Junior / Number of Football Letters Earned
State player or Conference Player of the Year in your classification:
Offense / Defense / Special Teams
Explain:
List individual offensive and defensive statistics and please indicate if they led the State or Conference:
Senior Year
Junior Year
Soph. Year
SCHOLASTIC ABILITY: (40%) Please complete this side of the nomination form with the
assistance of the Guidance Counselor. / ACT Score / SAT Score
Cumulative Grade Point Average (on 4.0 scale) / Class Rank / Number in Class
Please List any Advanced Placement or International Baccalaureate classes taken by the Nominee:
EXTRA-CURRICULAR ACTIVITES AND CITIZENSHIP: (20%)
Check any of the following that apply:
Student Body President / Senior Class Pres. / Junior Class Pres. / Soph. Class Pres.
Freshman Class Pres. / Any Other Class Officer or Representative
Explain:
Number of years as a National Honor Society Member / National Honor Society President
Number of Years as an officer of any school club / Explain:
Editor of yearbook / Editor of School Newspaper / FFA
Number of years as a member of All-State Band or Choir / FBLA/FCCLA
Explain:
Eagle Scout / Congressional Award Winner (Gold, Silver, or Bronze) / Explain:
Boys State Delegate / Boys State Officer / Explain:
All-State 1st Team in WHSAA / Explain:
All-State 2nd Team in WHSAA / Explain:
All-Conference 1st Team in WHSAA / Explain:
Team Captain in other sports / Explain:
Number of letters earned in other sports / Explain participation in other School Activities:
Explain Participation in Community Service Activities:
Nomination submitted by: / Signature of Principal
Signature of Athletic Director
Signature of Coach
Please attach a transcript and mail, E-mail, or FAX to Heath Hayes, 632 Harrison Street, Douglas, WY 82633, (FAX 307-358-1144), or . Thank you for your cooperation.
THE DEADLINE FOR THE RETURN OF THIS FORM IS FRIDAY, DECEMBER 1, 2017.