Hall of Fame Nomination Form

Name of Nominee*

First Name Last Name

Nominee Email*

Year of Nomination

OHSVCA District Number*

OHSVCA Member*

Total years as a head coach*

Years as other type of coach (specify)

Current/Last School Coached*

School Name Address City State ZIP Code

School Phone*

District Trustee/President*

Career Head Coaching Record*

Ohio Coaching Record ONLY

School	Years	Dates	Wins	Losses

Total Record at Varsity Level*

Wins	Loses

Nominee's Information

Current Address*

If nominee is deceased, please use info of closest relative

Street Address City State / Province / Region ZIP / Postal Code

Nominee Phone*

League

Type	Years

District

Type	Years

Regional

Type	Years

Other

Type	Years

Contributions to OHSVCA*

Contributions to their local association*

Other Comments

Family Members*

Birthplace*

Birth Date*

Parents*

High School*

Honors

College*

Honors

Addresses of Local Newspapers

Name	Address