Hall of Fame Nomination Form

Department of Intercollegiate Athletics

Athletic Hall of Fame
Official Nomination Form

(This form must be submitted by December 9, 2013 at 5:00 pm)

Nominee's Name   

Street Address   

City/State/Zip   

Phone   

Email   

Date of Birth   

Birth Place   

If Deceased, Name and address of nearest relative:   

Sports Participation as Player or Sports Coached:

SchoolYearActivities (H.S., College & Pro.)

Sports Information (records broken, coaching records, state championships, etc.)   

Honors Received (Olympic, All State, MVP, etc.):

YearActivity and Team of GroupContributions/Achievements

Any additional & significant information (include civic and community service):   

Year of Graduation and Major   

Present Employment   


Nominator Information

Nominee's Name   

Street Address   

City/State/Zip   

Telephone   

O/C   

Please check:
Alumnus
Family
Friend

If alumnus: What year?