Nominee ___________________________________________________________________
Nominee’s Home Address _____________________________________________________
City _______________________________ State _____________ Zip __________________
Home Phone ________________ Business Phone _________________ Email ___________
Division of Nomination: { Student-Athlete { Coach { Administrator { Alumnus
Class of _______________ Sport(s) __________________ Department _________________
Distinguishing Contributions/Achievements:
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___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
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Submitted by (please print) ____________________________________________________
Signature ____________________________________________ Date __________________
Submitters Phone __________________________ Submitters Fax _____________________
Address____________________________________________________________________
Email____________________________________
The nomination form, a short resume/bio and letter of recommendation are to be mailed to Director of Athletics, Union College, Alumni Gym, Schenectady, NY 12308 or faxed to (518) 388-8017.
