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Candidate's Full Name
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Current Address ____________________________________________________
City/State/Zip _______________________________________________________
Home Phone ______________________ Work Phone ______________________
Personal History (High School, College, Family, etc.) _____________________________________
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NCCC Athletic Affiliation (Month & Years) _______________________________________________
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Sports Coached or Participated in ____________________________________________________
NCCC Coaching or Athletic Records (list each sport separately) ____________________________
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Other Records ___________________________________________________________________
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Special Honors/Awards (Please include the name of the award and the year) __________________
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Name of Person Making Nomination __________________________________________________
Address _________________________________________________________________________
City/State/Zip _____________________________________________________________________
Home Phone ______________________ Work Phone ______________________
(continue on a separate page if necessary)
NOMINATIONS MUST BE SUBMITTED
BY FEBRUARY 1st DIRECTLY TO:
Niagara County Community College
Mr. Lee S. Wallace
Athletic Director
3111 Saunders settlement Rd.
Sanborn, NY 14132
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