Nomination Form

Utah Trapshooting Hall of Fame

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Nominee Information

Name of Nominee

Address

City

State

Zip

Resident of Utah and ATA member for 10+ years?

Age

Date of Birth

Year Started Competitive Trapshooting

Last Year of Competition

Shooting Merit

List 6 major championships won per ATA rules

1.

2.

3.

4.

5.

6.

Administrative Excellence

Describe the nominee's contributions

Additional Information

Is the nominee an Industry Representative?

Does the nominee have memorabilia to contribute?

If yes, describe the items

Is the nominee deceased?

If deceased, date of death

Nearest Relative

Name

Relationship

Address

Phone

City

State

Zip

Submitted By

Your Name

Utah Trapshooting Hall of Fame
PO Box 84 · Springville, UT 84663

A 501(c)(3) nonprofit corporation · Utah State Trapshooting Association