Hall of Fame Nomination

Hall of Fame Nomination

Please complete this form for nominations for the Hall of Fame. You can fill the following form out and submit this formusing the submit button at the bottom of the form via this website; once submitted you will be shown a printable page for your records.

Or you can print this page, fill it out and mail to the following address:

Virgil Haley
4113 Horseshoe Drive
Cedar Falls, IA 50613

questions? Contact: crzycoach@q.com

Nominee Name:
Select One:
Active years of Swimming/Diving/Coaching/Officiating:	from to
Current Street or Box Address:
City:
State:	Zip:
Home Phone:
Email Address:
Last Known Address:
High School Attended:
High School Coach:

ACCOMPLISHMENTS:
Year:

Year:

Nominator Information

Nominator:

Nominator Phone:

Nominator E-mail