Hall of Fame Nomination Form – Cabot Panther Foundation

Nomination Category (Check all that apply) *

Alumni
Former Faculty/Staff
Community Member

Candidate’s Name *

First

Last

Candidate’s Title and Occupation *

Candidate’s Address *

Address Line 1

City

State

Zip Code

Candidate’s Phone *

Candidate’s Email *

Please provide a summary (highlights) of the candidate’s career (And/or exceptional accomplishments) *

Please provide information pertaining to candidate’s extraordinary community or family service (Youth, Church, School, and Civic Groups) *

Sponsor’s Recommendation (Provide rationale for the committee to review when considering this nominee’s qualifications for the Panther Hall of Fame: Email copies of news clippings, magazine articles, photos or other documentation that may help with the committee’s selection to director@cabotpantherfoundation.org): *

You can email copies of all documentation to director@cabotpantherfoundation.org.

clippings, Graduation for

Provide three names, with telephone numbers or email address, of persons familiar with the achievements of this nominee *

Sponsor’s Name *

First

Last

Sponsor’s Address *

Address Line 1

City

State

Zip Code

Sponsor’s Phone *

Sponsor’s Email *