Goucher College Athletics Hall of Fame
Nomination Form

Name of Nominee: 
Current Address:
City: State: Zip:
Daytime Telephone: mar Mobile:
E-mail Address: Fax:
Birth Date: Marital Status/ Name of Spouse/Partner:
Child(ren)’s Name(s) and Age(s):
Goucher Class Year: Major:
Sport(s) played at Goucher:
Years of participation (e.g. 1976-1980):
Present Occupation/Title: Evening Telephone:

Activities, community service, memberships, etc...:

Category for Nomination:

In the space below, please provide information on the candidate you have nominated for the
Athletics Hall of Fame (e.g., why you feel the candidate is deserving of the recognition) and feel
free to make additional copies of this form if you would like to submit another candidate for
consideration. Please be specific with honors and dates. Also include any additional material
that would support the nomination (e.g., newspaper clips, game programs, school records,
testimonials from former coaches and players, photos, etc.). Please do not submit original items.

Primary Sport: Position or Events:
Additional sport(s) played:
Coach’s Name:

Honors Received:

Athletic achievements and statistics (Regional, National, Team or Individual
Championships):



Team or individual championships:


Athletic Accomplishments Post-Goucher (i.e. playing, coaching, officiating, etc.):



Nominator’s Name: Class Year:
Address: City: State: Zip:
Daytime Telephone Number: Mobile:
E-mail Address:


I attest that the above information is accurate and true to the best of my knowledge:
Initials:
Date: