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Athletic Hall of Fame Nomination Form
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Alumni Recognition
Athletic Hall of Fame
General Information
Name
*
First
Last
Name while at The Valley (if different from above)
Class Year
Current Address
*
Street Address
Street Address Line 2
City
State / Province / Region
Postal / Zip Code
Country
Daytime Phone Number
###
###
####
Evening Phone Number
###
###
####
Email Address
*
Office Email Address
Date of Birth
MM
DD
YYYY
Place of Birth
Deceased?
Not Selected
Yes
No
Education
College
Graduation Year
Major
College
Graduation Year
Major
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
Street Address
Street Address Line 2
City
State / Province / Region
Postal / Zip Code
Country
Community Involvement
Please describe any organizations or groups to which this person contributes or have contributed his/her time and talent. Please include any titles (i.e. president, chairperson) if applicable.
Post College Athletic Achievements
Please provide any additional information
Nominator Information
Name
*
First
Last
Email Address
*
Submit
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