Allegheny-Kiski Valley Sports Hall Of Fame
Nominee Stat Sheet

Please provide as much detail as possible.  If needed, attach additional information on separate sheets of paper.

Date of submission:  ____________________

Name of nominee__________________________________

Nick Name____________________Birth date___________

Address____________________________________________________________

Place of birth________________________________________________________

Business address_____________________________________________________

Business Phone______________________________________________________

Home Phone________________________________________________________

Name of spouse_____________________________________________________

Maiden name of spouse (if applicable)____________________________________

Names and ages of children____________________________________________

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High School attended & year of graduation________________________________

College attended & year of graduation___________________________________

Sports background, awards, achievements & honors________________________

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