Skip to main content
HOME
/
INDUCTEES
/
ABOUT
/
CONTACT
Newsletter
Brenda Reilly Fund
Photo Gallery
Nominations
Nomination Form
Your Information
Your Name
*
Your Email Address
*
Your Phone Number
*
Nominee's Information
Nominee's Name
*
Current Address
*
Home Phone
*
Business Phone
Current Position/Employer
*
High School Career
Graduate of
Year
Address
Sports Participated In
Team Achievement/Honors
Individual Achievement/Honors
College Career
Graduate of
Year
Address
Degree Recieved
Other College attended
Sports Participated In
Team Achievement/Honors
Individual Achievement/Honors
Coaching Career
Number of years coaching: College
Number of years coaching: High School
Win/Loss records: High School
Win/Loss records: College
Achievements as a High School Coach: Include league titles, State Titles, number of girls selected as “All-State”, number of girls to go on to play collegiate basketball, etc. Anything of importance:
Achievements as a College Coach: Include any pertinent information – see the suggestions listed under High School Coach
Career as a Referee
Year Began Career
Year Career Continued Until
Board of Officials worked for
Championships games you have offiicated
Honors that you have recieved
Highest rating that you have attained
Work Experience: High School
Work Experience: College
Honorary Nominee
List and briefly describe any work that you have done on various committees, etc. which have contributed to the enhancement of girl’s basketball in the State of Connecticut. This can include teaching, coaching, refereeing, supporting, publicizing, etc.
CAPTCHA
What code is in the image?
*
Enter the characters shown in the image.