Hall of Fame Nominations

Name of Nominee *
Current Address
Daytime Telephone
Mobile Phone
Email address *
Fax Number
Birth Date
Marital Status/Name of Spouse/Partner
Child(ren)'s Name(s) and Age(s)
Goucher Class Year
Years of Participation (e.g. 1999-2002)
Present Occupation/Title
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.)


In the below section, please fill in all applicable information about you, the nominator.

Nominator's Name *
Class Year
Daytime Phone Number
Mobile Phone Number
Emall Address


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

Initials *
Date *
* = required field