1. Candidate’s Name
3. Address
MM slash DD slash YYYY
(Date)
(Place)
(Place)
(Date of Death)
(Year of Graduation) (School Name) (City & State)
(Please list team or individual regular season and post-season record, by year; list individual stats, summarize records and awards.)
Address
8. Colleges Attended:
(Year) (Degree) (Field) (College)
9. Suggested category of nominee:
(please check one)
(Please list team or individual regular season and post-season record, by year; list individual stats, summarize records and awards.)
Address
(since graduation from high school and/or college)
(list yrs.) (Coaches – please fill out year by year and your record at each school)
Address
(List Names and Year of Birth)

IMPORTANT!
PLEASE ENCLOSE 2 CURRENT PHOTOS OF THE CANDIDATE,
AND AT LEAST ONE CANDID OR ACTION PHOTO OF THE CANDIDATE FROM THEIR PLAYING OR COACHING
DAYS.

This page is to be completed by the High School, College, Organization, or Individual Submitting the Application.

2. Address

Please submit 2-5 clippings, programs, or other printed materials that document some of the records and achievements listed herein. Letters of recommendation from peers (maximum of 3) are also appropriate.

Max. file size: 59 MB.
Consent
(Signature of person making nomination) (Date)

(Note: If additional space is needed, please use a plain sheet of white paper, 8½ × 11 inches, write on one side only, preferably typewritten.)

RETURN TO:

Gary Indiana Sports Hall of Fame
Nominations Committee
P.O. Box 641267
Gary, IN 46401
Phone: (219) 201-3658
Email: garysportshalloffame@yahoo.com

NOMINATIONS ARE DUE BY SEPTEMBER 1st TO BE ELIGIBLE FOR THE FOLLOWING CALENDAR YEAR CONSIDERATION (example: due November 1, 2022, for eligibility in 2023)

This field is for validation purposes and should be left unchanged.