Liberty University
Athletics Department
Hall of Fame Nomination Form
Nominee’s General Information
Name of Nominee:
________________________________________________________________________________________
Circle One: Student-Athlete | Coach | Athletics Administrator | Athletics Contributor
Nominee’s Current Contact Information:
Current Address:
_______________________________________________________________________________________
_______________________________________________________________________________________
Phone Number: (____) ____________________ Email: ____________________________________________________________
Nominee’s Athletic Information:
Year(s) of Competition at Liberty:
Sport(s) Nominee Played:
Major(s) at Liberty:
____________________________________________________________ (example: 1993-96)
____________________________________________________________________________
____________________________________________________________________________
Please list any collegiate accomplishments to support this nomination:
(Example: Academic honors, athletics honors, program and conference records, team accomplishments during his/her span with the
program, etc.)
Please list any post-collegiate competition opportunities or achievements to support this nomination:
(Example: professional/Olympic competition, significant contributions to his/her sport, excellence in his/her professional vocational
career, etc.)
Other pertinent information to support this nomination:
(Note: Please use this area to provide supporting information for Administrator/Athletics Contributor nominations, plus any other
relevant information for this student-athlete or coach nominations)
Nominator’s Contact Information:
Name of Nominator: ________________________________________________________________________________________
Affiliation with Liberty (Alumnus, employee, Flames Club member, friend, etc.) _______________ (If alumnus, please provide year)
Address: __________________________________________________________________________________________________
Phone: ( ___ ) _________________________________ Email: ______________________________________________________
Please return this form to Kevin Keys, chair of Liberty’s Athletics Hall of Fame committee:
Address: Kevin Keys, Associate Athletics Director, Liberty University, 1971 University Blvd., Lynchburg, VA 24502
Email: [email protected] – Fax: (434) 582-2076
Nomination Notes:
- To be eligible for the Liberty Athletics Hall of Fames, a student-athlete must be five years removed from competition.
- Nominations will be accepted throughout the year and will be evaluated prior to the selection of each year’s Hall of Fame class.
- You may include up to one additional page of supporting information, if necessary.