NOMINATION FORM

MISSOURI HORSESHOE PITCHERS ASSOCIATION HALL OF FAME

FOR USE BY SELECTION COMMITTEE OF MISSOURI HORSESHOE PITCHERS ASSOCIATION HALL OF FAME TO DETERMINE THE NOMINEE’S QUALIFICATIONS FOR INDUCTION.
(Please print or use typewriter)

NAME OF NOMINEE:  ____________________________________	 PHONE:  ______________________

ADDRESS:  ________________________________   CITY:  _______________________   ZIP: __________

CLUB AFFILIATION/S:  ______________________________________________________________

DATE OF BIRTH: __________________________	DATE OF DEATH:  _____________________


What do you consider the nominee’s most important achievement/s in horseshoes? Player:









Organizer:









Promoter:









What recognition has the nominee received for: Playing Ability, Leadership, Administration, Etc.?









What services, etc. has the nominee rendered or contributed toward the advancement and/or support of the sport of horseshoes?









In which category do you recommend the nominee be considered?
Player ___, Promoter/Organizer ___, Player/Organizer ___.



Submitted by:  ______________________________________________  Date:  ______________


Address: ____________________________________________________ Phone: _____________


Additional narrative may be attached. Please indicate ___Yes and number of total pages included_____.



Please refer to MOHPA HOF Standard Operating Procedure regarding HOF nomination and selection procedures before submitting your nomination – available at www.MOHPA.US or an MOHPA officer.