2012 UNCW Athletic Hall of Fame Nomination

05/20/2013

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Please complete the following information and click submit to nominate an individual for the 2012 UNCW Athletic Hall of Fame. Thank you.

Required Fields in Bold

	Candidate's Name (Last, First):

	Home Address:

	City:

	State:

	Zip Code:

	E-mail Address:

	Home Phone:

	Work Phone:

	Cell Phone:

	College Attended:

	Graduation Year:

	Degree:

	Major:

	Graduate Degree:

	Year:

	Collegiate Achievements - Academics:

	Collegiate Achievements - Athletics:

	Collegiate Achievements - Other:

	Professional Career - Current Employer:

	Position:

	Significant Achievements:

	Community Service:

	Current Volunteer Activities:

	Nomination Submitted by:

	Current Home Address:

	City/State:



	Phone Numbers:

	E-mail Address: