Athletic Hall Of Fame Nomination Form

First Name:

Last Name:

Street Address:

City:

State:

Zip:

Phone:

Email:

Nominee's current occupation/employer:

Men's Sports:
Baseball
Basketball
Cross Country
Football
Ice Hockey
Lacrosse
Soccer
Tennis
Co-ed Sports:
Sailing

Women's Sports:
Basketball
Cross Country
Field Hockey
Ice Hockey
Lacrosse
Soccer
Softball
Tennis
Track & Field
Volleyball

Athlete
Coach
Administrator
Team
Other

Nominee's year of graduation from Salve Regina (if applicable):

n/a 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002

Nominee's athletic highlights at Salve Regina? Please provide any additional information:

Full name of person submitting form:

Your telephone:

Your email: