HALL OF FAME NOMINATION FORM

 

The Los Angeles Valley College Athletic Hall of Fame is founded to honor, pay tribute to, and perpetuate the memory of those individuals who, either through participation, support, or interest, have made outstanding contributions in the field of intercollegiate athletics and who have helped to bring recognition, honor, distinction, and excellence to Los Angeles Valley College. So that we may properly evaluate your candiate, please answer the following:

 

 

 

Name of Nominee:      

 

Address:

 

City, State, Zip:        

   

 

Phone Number:     

         

 

Email:   

         

 

Nominated By:     

   

 

Your Phone Number:     

  

 

Your Email:                   

       

 

Your Address:                    

  

 

Your City, State, and Zip:

     

 

Was the nominee a student-athlete, coach, or...?

          

   
 

The sport the nominee is recognized for is:

  

 

Did the nominee break college records and if so, what?  

    

 

Did the nominee receive any state or national   
recognition or awards while at Valley, and if so,
please explain.

    

 

Did the nominee continue to have a
successful career at a four-year college
or university and if so, please name.

 

Was the nominee an Olympic athlete or coach
(Y / N)?      

                 

 

Did the nominee continue to have a successful   
professional career (Y / N)?    

              

 

Is the nominee alive or deceased?  

      

 

 If selected, can you assist in securing the  
 attendance of the nominee (Y / N)?

         

Can you provide the names and contact  
information of others who know the nominee
so  we may contact them if the nominee is  
selected?

 


 If yes, please provide on a separate sheet.

 

Additional Comments (limited to 100 characters; please include other remarks in email):