Southwestern Hall of Fame Nomination Form
For a printable form to fill out and mail in please click here.
Contact Information (of nominee):
Name:
Address (if known):
City:
State:
AL
AK
AZ
AR
CA
CO
CT
DE
DC
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip:
Home Phone:
Cell Phone:
Email Address:
Athletic and Academic achievements:
Current Occupation of nominee:
What years did nominee attend Southwestern:
Sports Played or Coached at Southwestern:
Sport(s) lettered in and year:
If athelete/coach participated in more than one sport, in which did he/she most excel:
List the reasons why you feel that this person should be inducted into the Southwestern University Athletics Hall of Fame; if available, include statistics and/or special accomplishments: