25 year application form by 9PW3wT

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									Louisiana High School Athletic Association
12720 Old Hammond Hwy
Baton Rouge, Louisiana 70816
225.296.5882
Fax: 225-296.5919


TO:             COACHES

SUBJECT:        LHSCA TWENTY-FIVE YEAR PLAQUES

      If you have served twenty-five or more years as a high school coach, would you
please fill in the form below and return it to this office so we can determine whether or
not your high school service qualifies you to receive this plaque. Please list the high
schools and parishes in which you worked, the sports you have coached and the years of
service in each school. Only high school service can be considered. Do not fill out the
form unless you have twenty-five years of service as a high school coach.

                                                    Sincerely,

                                                    Kenneth Henderson, Commissioner


 HIGH SCHOOL                          PARISH             SPORTS COACHED          DATES




NAME:                                                   SCHOOL:

HOME ADDRESS:                                           CELL PHONE:

CITY:                                          STATE:             ZIP CODE:

HOME PHONE:                                    SOCIAL SECURITY#

								
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