ITCCOA Hall of Fame Nomination Application


Name                                                                                                                                                        
                                                                         
Address                                                                                                                                                
                                                                 
City                                                                               State                                    Zip                        
    
Home phone                                                                 E-mail                                                                
                 
Did He/She Work Sectionals                Yes                No                  Boys            Girls                

Did He/She Work State                        Yes                No                    Boys             Girls                 

Was Nominee an ITCCOA Member                Yes                       No                

Number of Years Officiated                                                          

What Areas Were
Officiated                                                                                                                                                   

                                                                                                    

                                                                                                                     
Highest Rank or Position of  
Officiating                                                                                                                                                                          

                                                                                                                                                                                            
                                                                                                                                                                                      
Nominee Recommended By                                                                                                         
                                          
Address                                                                                                                                                
                                                                    
City                                                                           State                                 Zip                                 
  
Home Phone                                                          E-Mail                                                                         
                  
Official Level     X                R               C                          IHSA Number                                                 
  
ITCCOA Member   Yes               No                     Number of Years Officiated                                 

Include a short resume of the nominee’s accomplishments and achievements along with this page to:

Glenn Cothern                        or                Geza Ehrentreu
1037 E. 500 N. Road                                  3133 Ramsgate Road
Gibson City, IL  60936                               Rockford, IL  61114

Print this form and mail to one of the above officials.
Hall of Fame Nomination
Form
Nomination For Hall of
Fame