Hall of Fame Nominee Information Form

Email Secondary Email

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Email address *

First name *

Last name *

Address 1 *

City *

State *

ZIP Code *

Cell Phone Number *

Please list the sports in which the nominee particpated *

Graduation year *

Degree/Major Curriculum *

Please list all the available awards and honors (both academic and athletic) earned by the nominee *

Please list the recent employer and employment information of the nominee. If the nominee is retired, please list the year of retirement and last active place of employment of the nominee *

Please list any post-graduate experience of the nominee and any communtiy involvement completed by the nominee *

Please list any additional comments regarding the nominee *

To the individual nominating the athlete, please list your name, mailing address, email address and telephone number at which you can be contacted *

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