Hall of Fame Application
Email
Secondary Email
There are errors with your form submission. Please review and submit again
Nominee Name: *
Email address *
Nominee Employer: *
Nominee Address: *
Nominee Phone number: *
Category (Choose One): *
Student/Athlete
Friend/Special Contributor
Coach/Administrator
Group/Team
Other Considerations
List sport(s) nominee played/coached/administered/supported (if applciable) and the number of years involved with the particular program(s):
List nominee's special contributions/accomplishments during his/her years at North Country Community College:
Please provide a summary of why you feel this person(s) should be considered for the North Country Community College Hall of Fame: *
List Contacts who can provide additional information if need be. Please provide names, addresses, email and phone numbers for each contact.:
Name of person making nomination: *
Adress of person making nomination: *
Phone & Email of person making nomination: *
Date nomination is being submitted: *
Submit
* required field