Form
Centralia Sports Hall of Fame Nomination Form
Please use this form to submit nominations of individuals or teams to The Centralia Sports Hall of Fame.
Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
*
example@example.com
Individual or Team you are nominating
*
Category
Please Select
Individual
Veteran
VIP
Team
No Preference
Nominee's Contribution to Centralia area sports
*
Other individuals to contact regarding this nominee
Please upload any information or photos available
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please verify that you are human
*
Submit
Should be Empty: