Online Nomination Form

PIKEVILLE HIGH SCHOOL ATHLETIC HALL OF FAME
Online Nomination form

information about nominee

Name of the Nominee *

First

Last

Is the Nominee Deceased? *

Yes No

Gender of Nominee *

Male Female

Primary Category of Nomination *

Athlete Coach Contributor

Primary Sport for Nomination *

Year Nominee Graduated or If a Coach, Years Coached *

if nominee is not deceased please complete the information for them, if they are deceased (and if you know) please complete the information for a family member:

Nominee's Address *

Line 1

Line 2

City

State

Zip Code

Country

Nominee's Phone Number *

Nominee's Email *

information about the person making the nomination

Nominator's Name *

First

Last

Nominator's Address *

Line 1

Line 2

City

State

Zip Code

Country

Nominator's Phone Number *

Nominator's Email *

The following information is important to the selection process and is required In order to maintain the integrity of the program.

In addition, Nominees shall exemplify the highest standards of sportsmanship, ethical conduct and moral character. All candidates shall be judged on their significant or long-term contributions to Pikeville High School athletics.

Applications will NOT be accepted without this information.

Summarize this Person’s Accomplishments as a Player, Coach or Contributor at Pikeville High School and Why they should be considered for the Hall of Fame. *

Please Provide A Summary of the Supporting Materials that you have for your Nominee.

If possible please scan and upload these material below or you can copy and mail to the Committee. If you have materials that can not be copied or duplicated then please identify these items with an * in the summaries below and if these materials are needed then the Hall of Fame Committee will be in touch to make arrangements to view these materials.

Accomplishments *

Summary Of Other Supporting Information *

You Can Upload Your Supporting Information For Your Nominee Here: *

Max file size: 20MB

Please do not send originals, any information sent will not be returned.
If you wish you can mail copies of the supporting information to the following address or the they can be dropped off at the School:

Pikeville High School Athletic Hall of Fame
C/O Pikeville High School
120 Championship Drive
Pikeville, Ky 41501

By Clicking the submit button below You certify that You have truthfully completed this information about the nominee.

You also agree to cooperate with committee of the Pikeville High School athletic Hall of Fame should additional information be requested.

HAVE YOU DISCUSSED THIS NOMINATION WITH THE NOMINEE OR THEIR FAMILY AND WILL HE/SHE/THEY ACCEPT INDUCTION IF ACCEPTED. *

YES I HAVE NO I HAVE NOT DISCUSSED THIS WITH THE NOMINEE OR THEIR FAMILY

Submit Nomination Form

PIKEVILLE HIGH SCHOOL ATHLETIC HALL OF FAMEOnline Nomination form

information about nominee

if nominee is not deceased please complete the information for them, if they are deceased (and if you know) please complete the information for a family member:

information about the person making the nomination

By Clicking the submit button below You certify that You have truthfully completed this information about the nominee. You also agree to cooperate with committee of the Pikeville High School athletic Hall of Fame should additional information be requested.

PIKEVILLE HIGH SCHOOL ATHLETIC HALL OF FAME
Online Nomination form

By Clicking the submit button below You certify that You have truthfully completed this information about the nominee.

You also agree to cooperate with committee of the Pikeville High School athletic Hall of Fame should additional information be requested.