UC Davis Student-Athlete Legacy Award - Nomination Form

Launched in the 2010-11 athletics year, the Legacy Award honors former UC Davis student-athletes who have attained outstanding athletics achievement -- preferably on a national or international level -- since their departure from UC Davis that brings honor and prestige to the university and its athletics program. Criteria for selection is listed here.

Please fill out the following form as completely as possible. The deadline for nomination for any given induction class is November 30 of the previous calendar year (e.g. the deadline for the 20121 inductions is Nov. 30, 2011).

Thank you!

NOMINEE INFORMATION

Name:
Current Address:
City:
State:
ZIP:
Phone:
Email Address:
Hometown:
Degree:
Graduation Year:
Occupation:
Employer:
Work Address:
City:
State:
ZIP:
Parents' Names:
Birthplace:
Birthdate:
Primary Sport:
Head Coach:
Years Played:
Other Sport(s):
Head Coach:
Years Played:

POST-COLLEGIATE ACHIEVEMENTS

Please summarize the individual's post-collegiate accomplishments, including any awards or achievements won. You may paste online links into the space as needed. Any other documentation that cannot be transmitted through this form may be sent to the address at the bottom of the form.

Awards/Accomplishments:

Other Special Qualities:

NOMINATOR'S INFORMATION

Name:
Address:
City:
State:
ZIP:
Phone:
Email Address:
Relationship to nominee:

Thank you. Any additional supporting materials (e.g. letters, news clippings, etc.) may be sent to:
UC Davis Athletics Media Relations
120 Hickey Gym
One Shields Avenue
Davis, CA 95616