IMPORTANT - WHEN COMPLETING NOMINATION FORM
Please complete this Nomination Form thoroughly and use only this single page form. Please be
as specific as possible with factual information. All information will be reviewed for verification.
We are primarily interested in special honors, awards, noteworthy records, and significant
achievements along with the years these accomplishments were earned. Note: There is a one
calendar year moratorium for all individual nominations (Ex. A nomination received on any specific date
would make that nominee eligible on that date the following year). If appropriate information is
not provided your nomination may not be considered at this time.

Deadline date for nominations is April 1 of each calendar year.

PLEASE NOTE: Nomination Forms are due no later than April 1st of each calendar year. Forms are to be
submitted via email to gfashof@gmail.com. For information, contact Mr. Bob Root, GFASHOF
Executive Secretary, 9235 Jill Marie Lane, Swartz Creek, MI 48473, Phone: (810) 869-5179.

Click Here for a Printable Version of this Form

Distinguished Service Award Nomination Form
Nominee Name:
Address:
City:
State:
Zipcode:
Phone Number:
Living/Deceased:	Living Deceased
Sport(s) Area of Nominee's Major Involvement:
Nominee's Major Contribution to Greater Flint Area Athletics:
Available for Awards Ceremony:	Yes No
Flint Area person to contact:
Flint Contact Phone:
Flint Contact Email:
Submitted by:
Submitter's Phone Number:
Submitter's Email:
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Following our extensive review, final decisions are made in July of each year. A Press Conference is held in early October to announce the inductees and the Induction Banquet is held in early December. Prior personal notification of each nominee will be made, should he/she be selected, as acceptance is necessary. All nomination forms and related documentation of individuals not selected are retained in our files for review in the future. At present, over 25 nomination forms are on file. We thank you for your nomination and we sincerely appreciate your continued interest in the Greater Flint Area Sports Hall of Fame.