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Watervliet Athletic Hall of Fame Online Nomination Form

Items marked with an asterisk are required. Please be sure to fill out the form completely before hitting the send button!


*Nominee's Home Address:

Nominee's Home Phone:

Nominee's Business Phone:

Nominee's Email Address:

*Division of Nomination:

(please pick one)
  Student-Athlete       Coach       Administrator       Alumnus

*Class of:


*Distinguishing Contributions/Achievements:

Please type why you think this person deserves to be a
member of the Watervliet Athletic Hall of Fame.

*Submitted by:

*Submitter's Phone Number:

Submitter's Fax Number:

*Submitter's Email Address: