LVC Athletic Hall of Fame Candidate Form

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LVC Athletic Hall of Fame Candidate Form

Full Name *

First

Last

Name while at The Valley (if different from above)

Class Year

Current Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Preferred phone number

Preferred phone type

Cell
Home
Work

Preferred email address *

Education

College

Graduation Year

Major

Post-undergraduate institution (if applicable)

Graduation year

Degree received

College Athletic Record

(Honors, School Records, Team Records, Captainship, etc.)

Sport

Years played

Number of letters

Years as captain

Individual honors

School records

Team honors

Sport

Years played

Number of letters

Years as captain

Individual honors

School records

Team honors

Occupation

Current occupation

Current employer

Employer's address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Community Involvement

Please describe any organization or groups to which you contribute or have contributed time and talent. Please include any titles (President, Chairperson) if applicable.

Post college athletic achievements

Please provide any additional information