Please fill out all fields, if applicable. The * denotes a required field.

Nominee:*

Title*:

Institution*:

Address*:

City*:

State*: AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY AS GU MP PR VI   Zip*:
Phone:*

Fax:

E-mail address*:
  

Nominator:*

Title:

Institution:

Address*:

City*:

State*: AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY AS GU MP PR VI   Zip*:
Phone:*

Fax:

E-mail address:*

Recommendation (required): Please include a brief typed one-page (not more than 500 words) recommendation as to why this athletics administrator deserves to receive the award.  Nominees must meet the award criteria for consideration.*

Biography (optional):  Though not required, please furnish a biography that might be helpful to the nomination (i.e., resume, vitae, personal biography, etc.).