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Please
Note: This form is not activated
electronically, so please send your nomination to hof@emasslacrosse.org
and we will respond via
email.
Sorry for the inconvenience, we are
working diligently to get the form
activated.
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| Nominee
Contact Information |
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| Nomination
Date: |
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| First Name: |
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| Last Name: |
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| Street
Address: |
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| Street Address
2: |
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| City: |
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State: |
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Zip: |
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| Home
Phone: |
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Work
Phone: |
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| E-mail
Address: |
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| SECTION I - PLAYING
CAREER |
High School
Information |
| High School
Attended: |
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| Years
Attended: |
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| Years
Varisty: |
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| League/State
Championships: |
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| Years & Locations: |
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| Honors: |
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College Information |
| College
Attended: |
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| Years
Attended: |
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| Years
Varisty: |
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| League
Championships: |
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| Years &
Locations: |
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| NCAA
Championships: |
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| Years &
Locations: |
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| Honors: |
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Club Information |
| Club Team
1: |
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| Club Team 1
Years: |
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| Club Team 1
Honors: |
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Club Team 2: |
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| Club Team 2
Years: |
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| Club Team 2
Honors: |
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National Team
Information |
| National
Team: |
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Years: |
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Position: |
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| Honors: |
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All-American
Information |
| Team
Name: |
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| Team Voted To
(1st, 2nd, etc.): |
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| Dates: |
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All-Star
Information |
| High School
All-Star Team: |
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| Game
Title(s): |
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| Location(s) and
Year(s): |
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High School All-League Team: |
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| Game
Title: |
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| Location and
Year: |
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College All-Star Team Name: |
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| Game
Title: |
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| Location and
Year: |
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College All-League Team Name: |
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| Game
Title: |
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| Location and
Year: |
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Other All-Star Team Name: |
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| Game
Title: |
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| Location and
Year: |
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Other All-League Team Name: |
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| Game
Title: |
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| Location and
Year: |
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| SECTION II - COACHING
CAREER |
Head Coach School/Program: |
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Level: |
Varisty
JV
Freshman
Youth
Club |
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Years: |
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Championships: |
National
State
League
Club |
| Years &
Location: |
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Asst. Coach School/Program: |
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Level: |
Varisty JV Freshman
Youth
Club |
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Years: |
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Championships: |
National
State
League
Club |
| Years &
Location: |
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International Team/Program: |
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Position: |
Head
Coach Assistant
Coach |
| Championships: |
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| Year(s) &
Location(s): |
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| SECTION III -
OFFICIATING/UMPIRING CAREER |
Position: |
Official
Umpire |
| Numer of
Years: |
Local: District: National:
Int'l: |
| Championship
Events: |
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Years: |
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Locations: |
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| SECTION IV -
SERVICE |
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(Offices held in any recognized local,
state or national lacrosse organization
such as the NEILA, NIOLA, IWLCA, USILA,
USCLA, NILA, The Lacrosse Foundation,
USLacrosse, etc. Please specify position
and dates.) |
Offices Held: |
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Dates: |
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Committees Chaired: |
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Dates: |
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Committee Memberships: |
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Position: |
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Dates: |
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| SECTION V -
INDIVIDUAL HONORS |
| (Any
individual honor as a player, coach,
umpire/official or contributor to
lacrosse which are not already listed on
this questionnaire.) |
Honor: |
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| Date: |
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Honor: |
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| Date: |
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| SECTION VI - PERSONAL
BACKGROUND INFORMATION |
| (Indicate any other
honors have you received from athletic or
non-athletic endeavors, including
professional and personal
achievements.) |
Honors: |
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| Additional
Statements: |
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SUBMISSION |
| (Please fill in the following
fields with the Nominator's
information.) |
| Nominator's First Name: |
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| Last Name: |
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| Street
Address: |
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Street Address 2: |
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| City: |
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State: |
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Zip: |
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| Home
Phone: |
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Work
Phone: |
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| E-mail
Address: |
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USLacrosse will not sell, distribute or
spam submitted nominee form information.
Information will be used solely for Hall
of Fame Nomination purposes. |
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