East Rockaway Athletics

Retired Number Nomination Form

Name of Nominee: __________________________________________

Sport played & number to be retired: _________________ Number: __________

Graduation Year: _____________

Nominees’ information:

Contact information: e-mail ________________________________________________

(H) Phone: ________________________ © Phone _________________________

Address ________________________________________________________________

Name of person nominating the athlete: _______________________________________

Contact information: e-mail ________________________________________________

(H) Phone: ________________________ © Phone _________________________

Address ________________________________________________________________

Accolades the Athlete garnished: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Why you believe this nominee should have their number retired: ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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