Nominate

Please make sure the candidate you wish to nominate meets the Enshrinement Requirements specified on this site.

To download a nomination form click here.

Online Nomination Form

"*" indicates required fields

Name*

First Middle Last

Address

Street Address City State ZIP / Postal Code

Phone*

Email*

Date of Submission*

High School and Date of Graduation:

College and Date of Graduation:

Below, list all of the significant accomplishments of the nominee, both as a Rockland County resident and otherwise. Please be as specific as possible. Include varsity sports played in high school and college, dates, letters earned, honors won, records set, post-collegiate achievements, etc.

Nominating Person Info

Nominating Person's Name

First Last

Nominating Person's Address

Street Address City State / Province / Region ZIP / Postal Code

Nominating Person's Phone

Nominating Person's Email

Attach A Photo

Max. file size: 512 MB.

If you'd like to send a photo, just click Browse and choose the photo. It must be a jpg, pdf or gif ONLY.

If you wish to mail us a photo instead please mail in one to the address below.

Bill Rubbert
Chairman of the Selection Committee
189 Ridge Road
Valley Cottage, New York 10989
billrubbert@gmail.com

*If you are mailing in a photo, but have nominated using online nomination please include a note stating that.