Maryland State Athletic Directors Association

MSADA Maryland State Athletic Directors Association Hall of Fame Nomination Application

Presented to past Athletic Administrators for outstanding contributions to athletics in their school and community. Candidate must be at least a MSADA retired member. Nominations are due by February 1st

Nominee’s Name: ______MSADA Member: Yes No

Home Address: ______

Home Phone Number: ______

School(s): ______

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High School(s) Attended (include city and state): ______

College/University Attended and Degree Earned: ______

Athletic Participation (include level such as high school, college, professional) ______

Championships and Athletic Honors and Awards: ______

Sports Coached (include level and number of years): ______

Championships and Coaching Honors and Awards (include sport and level): ______

Revised: 2015 over Brief Athletic Administrator Career Summary (include positions held, locations, years of service etc.): ______

Professional Affiliations, Activities, Offices held (MSADA, NIAAA, NFHS, etc.): ______

Athletic Administrator Honors and Awards: ______

Services to the Community: ______

Significant Achievements to the Field of Athletic Administration: ______

Other Information You Would Like to Have Recognized: ______

Endorsed by:

Name:______Supervisory Position:______Contact Information:______Telephone Number:______Email Address:______

Submit completed form to:

Jason Woodward, CMAA or Carol M. Satterwhite, CAA Awards Committee Chairperson MSADA Executive Director Gaithersburg High School 5467 Gloucester Road 101 Education Blvd Columbia, Maryland 21044 Gaithersburg, Maryland 21704 [email protected] [email protected] Revised: 2015 over Revised: 2015 over