Berry High School/Academy Athletic Hall of Fame Nomination Form

Person submitting nomination form:    Date:   


Home Phone: 

Cell Phone: 

Work Phone: 



Name of Nominee: 

Nominee Address:   

Nominee Home Phone: 

Nominee Work Phone: 

Nominee Cell Phone: 

Nominee Email: 


Nominating Category (check all that applies)


Years nominee attended Berry High School/Academy:  

Year nominee graduated:  

Collegiate Attendance (Institution, Years, Degree) 


Basis of Nomination 

Please provide information that will substantiate the basis for the nomination in one of the categories listed below. Be specific with regard to any awards or honors including the year the award was bestowed and the awarding entity.  

Student-Athlete Achievements (e.g., All-Conference, All-Region, All-State, Athlete of the Year, record holder, etc.) 

Coaching Record/Achievements (e.g., Overall win/loss record, championships, Coach of the Year, etc.) 


Administrator Achievements (e.g., institution, position, how they influenced and/or  advanced athletic at Berry, etc.)


Other Pertinent Information

Please include and attach any and all information you feel is pertinent to the nominee's candidacy including, but not limited to, academic achievements/performance, community and/ or profession service activities, sportsmanship. 



Submitted by:      Position: 

 attest to the information provided in support of this nomination is accurate.