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:
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: