Official Nomination Ballot

Official Nomination Ballot

Hawai'i Sports Hall of Fame
(2022 Deadline is December 31, 2021)
Nominee Name

First Name Middle Name Last Name
Nominee Current Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Nominee Daytime Phone
Please enter a valid phone number.
Nominee Evening Phone
Please enter a valid phone number.
Nominee Email Address
example@example.com
Born in Hawaii

Yes No
If not born in Hawaii, where?
Hawaii Residency
From (year) to (year)
Nominee Date of Birth

Month Day Year
Date
Status

Living Deceased
If Deceased, Date of Death
If Deceased, Name of Closest Living Relative
Family Relationship (Son, Daughter, etc.)
Address of Living Relative

Street Address

Street Address Line 2

City State / Zip Code

Phone Number
High School Attended by Nominee
Year Graduated
College Attended by Nominee
Year Graduated
Category of Nomination

World Champion World Record Holder Olympic Medalist Contributor Pioneer Other
If needed, please provide additional information or elaborate on your choice:
Nominee Performance(s) Being Considered for Nomination

1. List performance(s) of the Nominee in chronological order in the box below.
2. Provide supporting documentation (clippings, etc.) by attaching below.
3. Provide a non-returnable action photo of the Nominee by attaching below.
Uploading Supporting Documentation (clippings, photos, etc.)

Cancel of
Nominated by:

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Daytime Phone
Please enter a valid phone number.
Evening Phone
Please enter a valid phone number.
Email
example@example.com
Relationship to Nominee
Signature

Clear
Date of Nomination

Month Day Year
Date
Criteria for nomination can be found on the Hawai'i Sports Hall of Fame website at this address: hawaiisportshalloffame.com/selection-criteria.html

Individual accomplishments of current Hall of Fame members are available on our website.

You can submit this form electronically by clickiing on the SUBMIT button below - or - you can PRINT the form and send with supporting documentation (if any) to this address:

Hawai'i Sports Hall of Fame
PO Box 201417
Honolulu, HI 96820-1355
Should be Empty: