Athletic Hall of Fame Nomination Form
Nomination form to honor former athletes, coaches, and contributors, who have brought recognition to
themselves and the Lenape Regional High School District between 1960 and 1985 either through
their athletic excellence, coaching achievement or their dedication to athletics in the school community.
For Lenape High School Hall of Fame – Induction Fall 2009
Please complete this form with as much information as possible.
It will be reviewed by the Athletic Hall of Fame Committee.
Nominee's Personal Information
Fill in each of the following fields:
Nominee's Name:
Date of Birth:
For Athlete
Class of:
For Coach
Sport:
Years:
Type Information About The Contributor Here:
Home Address, Phone, and E-mail
Street:
City,State,Zip:
Home Telephone:
Cell Phone:
E-mail:
Work Information, Address, Phone
Profession:
Firm Name:
Business Address (Street):
City,State,Zip:
Business Phone:
Family Information
Spouse:
Name of child 1:
Name of child 2:
Name of child 3:
Name of child 4:
Nominee's Athletic Information
High School Sports
Sports Played:
Positions Played:
Varsity Letters Earned:
Honors Earned by Nominee while at Lenape High School
Nominee’s Post High School Information
College Information
College Attended:
Major/Degree:
Year Graduated:
Sports Played:
Letters Earned:
Honors:
Nominee’s Post Graduate/Professional Accomplishments
Military Service Information
Nominee As Coach or Contributor
Please detail their outstanding contributions
Education (High School, College, etc.)
Awards and Honors received (athletic and non athletic)
Nominator's Information
Fill in the following
Nominator's Name:
Street:
City,State,Zip:
Telephone Number:
E-mail Address:
PLEASE SUBMIT THIS APPLICATION BY JUNE 30, 2009.
