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NOMINEE: _____________________________________________
NOMINEE
CATEGORY: Check (or complete) all that is applicable:
Deceased
_____ Living _____
Driver _____ Car Owner _____ Mechanic _____ Sponsor _____
Track Official _____ Promoter _____ Media _____ Other (specify)
_____
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BASIS FOR THE NOMINATION (list significant accomplishments or
significant long-term contributions to Pittsburgh area auto
racing, racetracks if applicable, time period, etc.):
NOMINATED
BY: _________________________________________________ DATE:
_____________
Phone:
________________________________ e-mail _______________________________________
HALL
OF FAME COMMITTEE APPROVAL:
1. __________________________________________
Date: _______________________
2. __________________________________________ Date: _______________________
3. __________________________________________ Date: _______________________
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