Name of Nominee:

Birth Place:

Birth Date:   Death Date:

Occupation:

Select Inductee Eligibility from the 4 areas described above -
PEOPLE: A or B                                                    HORSES: C or D

Please explain in detail why the nominee has contributed significantly to Indiana harness racing.  "People" Category should include names of horses, associates, and service organizations of nominee, as well as any other important information emphasizing the nominee's worthiness for induction.  "Horse" Category should include racing performance and production records, as well as any other important information.

         

Tell us how to get in touch with you: (*Denotes Required)

*Name of Nominator:   Date:

*Street Address:

*City:   *State:   *Zip Code:

*Home Phone:   Work Phone:   Fax:

*e-mail Address:

The following is not required for nomination to be considered.  It will, however, help ISHF in compiling research and background information, should the nominee be selected for induction.

Anecdotes / Remembrances / Humorous Stories About Nominee:

         

Other Information:

       

Others who might provide additional historical information about the Nominee:

Name:   Relationship:

Street Address:

City:   State:   Zip Code:

Home Phone:   Work Phone:   Fax:

E-mail Address:

Nominee (or family if Nominee is deceased) Contact Information:

Name:   Relationship:

Street Address:

City:   State:   Zip Code:

Home Phone:   Work Phone:   Fax:

E-mail Address:

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This form will be submitted directly to the chairman of the
Indiana Standardbred Hall of Fame.