Hall of Fame Nomination Form

 Minnesota Track and Field Hall of Fame

2009 Nomination Form

Please provide information about yourself so the committee may contact you if necessary:

Name: _______________________________________________________

Address: _______________________________________________________

City: ____________________ State: ____ Zip Code: __________

Phone: ____________________ (Include area code.)

Please provide information about the individual you are nominating:

Name: _______________________________________________________

Address: _______________________________________________________

City: ____________________ State: ____ Zip Code: __________

Phone: ____________________ (Include area code.)

Nomination is (check one):  Elite Athlete  Veteran Athlete  Administrator/Coach

List as many noteworthy performances or accomplishments as known. Include dates if possible:

 

 

 

Mail to Tim Zbikowski, 11270 E French Lake Road, Maple Grove, MN 55369

Deadline for submission of nominations is June 30, 2009.