Hall of Fame Questionnaire

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Biographical Information

Full Name(*)

Please enter your full name.

Preferred Name

Please enter your preferred name.

Email Address(*)

Please enter your email address.

Street Address

Please enter your street address.

City

Please enter a city.

State

Please choose a state.

ZIP code

Please enter a ZIP code.

Home Phone

Please enter your home phone.

Cell Phone

Please enter your cell phone number.

Birthplace

Please enter your birthplace.

Birthdate

Please enter your birthdate.

Spouse's/Significant Other's Name if applicable

Please enter your spouse's name.

Spouse's/Significant Other's Maiden Name if applicable

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Spouse's/Significant Other's Albion Class Year if applicable

Please enter your spouse's class year.

Spouse/Significant Other's Cell Phone if applicable

Please enter a cell phone number.

Spouse/Significant Other's Email if applicable

Please enter an email address.

Names and Ages of Children if applicable

Please enter the names and ages of your children.

Upload your picture Accepted file types: .jpg, .jpeg, .gif, .png; Max file size: 10MB

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Employment Information

Employer

Please enter your employer.

Title or Position

Please enter your title or position.

Business Address

Please enter your business address.

Business Phone

Please enter your business number.

Employment History with Dates most recent first

Please enter your employment history.

Honorary affiliations and offices

Please enter any honorary affiliations and offices.

Education

Degree 1

Class Year

Please enter the appropriate class year.

Degree / Major

Please enter the appropriate degree.

Institute

Please enter the appropriate school or institute.

Academic Honors

Please enter any honors.

Degree 2

Class Year

Please enter the appropriate class year.

Degree / Major

Please enter the appropriate degree.

Institute

Please enter the appropriate school.

Academic Honors

Please enter any honors.

Degree 3

Class Year

Please enter the appropriate class year.

Degree / Major

Please enter the appropriate degree.

Institute

Please enter the appropriate school.

Academic Honors

Please enter any honors.

Degree 4

Class Year

Please enter the appropriate class year.

Degree / Major

Please enter the appropriate degree.

Institute

Please enter the appropriate school.

Academic Honors

Please enter any honors.

Degree 5

Class Year

Please enter the appropriate class year.

Degree / Major

Please enter the appropriate degree.

Institute

Please enter the appropriate school.

Academic Honors

Please enter any honors.

Involvements

Organization, club and athletic affiliations as an alumna/us

Please enter any organizations and clubs you were affiliated with while attending Albion.

Awards, honors or recognition earned through work or volunteer efforts

Please enter any awards, recognition, offices held or honors received post graduation.

Military Service

Please enter any hobbies.

Hobbies

Please enter any hobbies.

Local media contacts newspapers, television/radio stations to send press release – if possible, please include email, fax number or mailing address

Please enter any hobbies.

Athletic Achievements

Albion sport and letters earned

Please enter any Albion sports and letters earned.

Albion College athletic awards

Please enter any Albion College awards.

MIAA Conference Awards

Please enter any MIAA Conference Awards.

National Awards

Please enter any National Awards.

Records and statistics (copies of photos, clippings, and programs are also helpful but cannot be returned)

Please enter any records and statistics.

Athletic achievements after Albion

Please enter any athletic achievements after Albion.

Personal Statement

Please provide any other pertinent information for use in printed programs, remarks, or other

Please enter a personal statement.

Invitations

Do you need lodging Friday night? If so, we can help you with reservations.(*)

YesNo

Please indicate whether or not you need lodging Friday night.

If yes, how many rooms

Please enter the number of rooms.

Dinner is complimentary for you and a guest. Please indicate below who will be joining you.

Guest Name

Please enter a guest's name.

Guest Address

Please enter a guest's address.

Guest Phone

Please enter a guest's phone number.

Guest Email

Please enter a guest's email address.

In addition to your two complimentary seats, please list names, full mailing and email addresses of family members and friends you would like to have invited to the dinner and awards ceremony.

Additional Guest(s) 1

Guest Name

Please enter a guest's name.

Guest Address

Please enter a guest's address.

Guest Phone

Please enter a guest's phone number.

Guest Email

Please enter a guest's email address.

Additional Guest(s) 2

Guest Name

Please enter a guest's name.

Guest Address

Please enter a guest's address.

Guest Phone

Please enter a guest's phone number.

Guest Email

Please enter a guest's email address.

Additional Guest(s) 3

Guest Name

Please enter a guest's name.

Guest Address

Please enter a guest's address.

Guest Phone

Please enter a guest's phone number.

Guest Email

Please enter a guest's email address.

Additional Guest(s) 4

Guest Name

Please enter a guest's name.

Guest Address

Please enter a guest's address.

Guest Phone

Please enter a guest's phone number.

Guest Email

Please enter a guest's email address.

Additional Guest(s) 5

Guest Name

Please enter a guest's name.

Guest Address

Please enter a guest's address.

Guest Phone

Please enter a guest's phone number.

Guest Email

Please enter a guest's email address.

(*)

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