St.

Charles County Amateur Sports Hall of Fame

Induction Evaluation Application

Minimum Qualifications for Consideration:

1. A candidate must have reached 45 years of age by October 31st to complete the application.
2. Have participated in Baseball, Fast-Pitch Softball, Bowling, Dartball, or Horsehoes for at least
10 years post high school as an amateur in the St. Charles County area.
3. The supplied information must be verified by a contemporary.

Participants meeting the above criteria will be considered but not guaranteed induction.

Evaluation Data

For use by the Selection Committee of the St. Charles County Amateur Sports Hall of Fame to
determine the Applicant’s qualifications for induction.

Sport Applied: Baseball Fast-Pitch Softball Bowling Dartball Horseshoes

(Please Circle)

(Please Print)
Name of Applicant__________________________________________________________________________

Address________________________________________________________State__________Zip___________

Phone______________________________________________

Email Address___________________________________________

Date of Birth________/_______/________

If a posthumous application Date of Death________/________/________

Please complete the following information:

What do you consider your top most important achievements in Amateur Sports?

What services, etc., have you rendered or contributed toward the advancement and/or support of
Amateur Sports?

What recognition(s) have you received for playing ability, leadership, umpiring, administrative,
member of Pennant and/or Championship team(s), etc.?
List in order of year, Names of Teams, Position and Years of participation.
List in order of year, Names of Leagues, Coach and Manager’s Name.

Other information that may warrant consideration.

High School Attended_______________________________________________Years____________________

College Attended____________________________________________________Years____________________

I hereby declare that all statements and information made herein are true and complete to the best of
my knowledge and recollection, and authorize the St. Charles County Amateur Sports Hall of Fame to
verify and to otherwise use this data as they see fit. This application incurs no obligation on either
party.

Signature of Applicant_________________________________________________________________

Date________/________/________

Please return completed application no later than October 31st

to:
St. Charles County Amateur Sports Hall of Fame
Becky Witt, Secretary
2134 McGregor Circle or EMAIL ADDRESS:
Dardenne Prairie, Mo. 63368 mailto:bwitt709@gmail.com
Or call 636-443-5660