Officiating Distinguished Service Award Nomination Form

Description of Award: This award is designed to recognize and reward those individuals who go above and beyond in service to their fellow officials. This does not require but could involve service to the MSHSL. This award is not based on the person's ability or skill as an official, but instead is dependent upon the leadership and service provided. This award should go to officials who have made a difference in their sport(s) through long term service and commitment.

Criteria for the Award: To qualify for this award an official must have been an MSHSL registered official for at least ten years. Service and leadership include current and/or past service.

Application Timeline and Process: The annual application deadline is January 20th. Award recipients will be selected and notified by mid-February. Awards will be presented at the Boys Basketball State Tournament.

Name of Person being Nominated

Address (person being nominated)

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Phone Number (person being nominated)

E-Mail (person being nominated)

1. Number of years as MSHSL Registered Official:

2. Number of years as a member of association (if applicable):

3. List and describe service provided to an association and their peers. This could include leadership positions held. Be specific and include the length of time over which this service/leadership was provided. Also include the impact this service has had on the association or their fellow officials:

4. Describe service to MSHSL Officiating Program and members schools (if applicable):

5. List and describe service to the community, member schools, or youth programs:

6. List and describe other service or accomplishments, on or off the field/floor/court/ice/pitch, etc. that would be applicable for this award:

Please attach two letters of recommendation for this award:

Maximum 5 files.
100 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.

Please attach any other information that would support this nomination (not required):

Maximum 5 files.
100 MB limit.
Allowed types: txt, rtf, pdf, doc, docx, odt, ppt, pptx, odp, xls, xlsx, ods.

Submitter Information

Name of Contact Person (person submitting this application)

Phone Number (person submitting the application)

E-Mail (person submitting the application)

This application will not be considered unless the entire application is completed. Please note that the MSHSL Awards Selection Committee may request additional information regarding any nomination.