CROOKSVILLE HIGH SCHOOL HALL OF FAME

NOMINATION FORM

1. Must be made by an individual other than the nominee.

2. Criteria for nomination can be found on http://www.crooksville.k12.oh.us/

3. All lines of this form must be completed in detail or marked N/A (not applicable).

4. A written cover letter must be signed and accompany this nomination form.

5. A nomination form must be submitted to the Athletic director’s office by April 1st

6.All nominees must be of good moral character and of an ethical background. The individual must be and have been a positive influence on the community of Crooksville and its schools. No nominee may have a loss of educational and/or activity licensure either through suspension, repeal, or resignation. No nominee may have resigned his/or position as either an athlete or coach through terms that are unbecoming of ones actions and/or character. All nominees must be the epitome of character and moral value and represent what is great about the spirit, community, and pride of a Ceramic.

(Please Print) Nominee’s Name:	Phone:
Address:
City:	State:	Zip:
Nomination Category (Please Check)	Athlete	Coach	Honorary Membership
Graduate of ( X )	Crooksville H.S.	Year of Graduation:
Coached for ( X )	Crooksville H.S.	Years Coached:
High School Sports Played:
Honors Won / Records Set:
College Attended:	Sport(s) Played:
Honors Won / Records Set:
Professional Sport (s) Played:
Professional Team (s):
Honors Won / Records Set:
Community Service Contributions and / or Occupational Accomplishments:
Comments Why Nominee Should Be Elected:
Nomination Made By:	Signature:
Phone:	Cell Phone:
Mail form to: Crooksville Athletic Director, 4075 Ceramic Way, Crooksville, OH 43731