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Return NO LATER THAN September 1st to:
 PSHF, Inc.
P.O. Box 7152
Lancaster, PA 17604-7152

(Please submit through your Senior Regional Vice President)

Part I - Nominating Requirements



Each Chapter may nominate not more than three (3) living and two (2) deceased.

Living Nominees: Must have been retired from sport or position minimum of three (3) years; OR, Been in sport or position minimum of twenty-five (25) years; OR, Reached their fifty-fifth (55th) birthday; AND, ATTEND Annual Induction Ceremonial.

Deceased Nominees: Must have been deceased minimum of one year; AND Furnish name, address and telephone information of individual's representative who will attend Annual Induction Ceremonial.

Completing Nominating Form: Form must be completed with accuracy and neatness; the Nominating Form will be returned to Chapter if errors are found, or biographical sketch does not accurately reflect dates or accomplishments.



Part II - Nominee's Personal Data



First Name: * MI:
Last Name: *
Address:
Address 2:
City: State: Zip:
Phone Number:
Email Address: *


Birth:

Date:
Place:
Age:
 
Sport:
Year Entered:
Year Retired:


(If Nominee Is Deceased Complete Following)



Date of Death:
Place of Interment:
Individual Attending Induction Ceremonial: Relation:
Address:
Address 2:
City: State: Zip:
Phone Number:


Nominee's Biographical Sketch



(Not to Exceed 75 Words - Attach a photograph)
Information Contained on this biographical sketch will appear on all ballots, media releases, inductional ceremonial programs, and program introductions; We emphasize the importance for accuracy; Don't embarrass your nominee.


Nominee's Photo:

Nominee's Bio:


Questions/Comments:
 
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Pennsylvania Sports Hall of Fame
PO Box 7152 • Lancaster, PA 17601
Phone: (717) 684-2714 • Fax: (717) 684-0013
Email: info@pashof.org

©2012, Pennsylvania Sports Hall of Fame. All Rights Reserved.