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Page 1

2021-10-06 US Rugby Hall of Fame Header w Logos (Final)
Hall of Fame Criteria Review


Nominee Basic Information

Enter Nominee Last Name


This Field is not required.


Format: MM/DD/YYYY

Enter Age in years (YY) of Nominee during year of Nomination, or Age at Death if deceased.

Use pull down menu to select: "Living" or "Deceased" (If Deceased is checked, use the Nominator information for the required contact information).
Nominee Contact Information

Format (john.jane.doe@namemail.com)

Enter the phone number with dashes. If the number is outside the USA enter the entire number with the Country code.



If outside USA enter the appropriate state designation.

Enter the Zip Code (USA) or Postal Code (outside USA) for the Current Address of the Nominee.

Enter the Country for the Current Address of the Nominee. Use "USA" if in USA.
Nominee Rugby Playing History Summary

Example: 1975, Age 26

Example: 2010, Age 62 (Include Seniors games if competitive tackle Rugby.)

Did the Nominee play Rugby at the International and/or Professional Level, and is the Nominee being nominated in the Player Category? If "yes" fill in the questions in this section. If "no" the questions will not appear, and you can skip to next section.
Nominee Last High Level Game Played

Example: USA Eagles 15, Japan, Gloucester, England.

Format: MM/DD/YYYY. The Hall of Fame requires that there be 3 full calendar yrs after this date before a Nominee may be considered for the US Rugby Hall of Fame. This Field only applies to Nominees applying for the "Player" category. Others may leave this Field blank.

Page 2

High School - Years, Accolades/Awards:

High School 01 - Sport History Summary

Enter the Name of the First High School attended (Designated as 01 for this Form

Enter the Location of the First High School attended (Designated as 01 for this Form). Enter (City, State, Country) Example: Woodside, CA, USA.

Enter the Last Year (YYYY) the Nominee attended High School 01

Enter the First Year (YYYY) the Nominee attended High School 01

If the Nominee considers multiple sports he/she played to be of equal importance, pick one sport here and list the next sport(s) below.

List Years, Achievements and Accolades for High School 01 Sport (Primary).

List by Yrs Other Sports, Yrs, Accomplishments, Accolades, Awards, etc.

List by Yrs Other Sports, Yrs, Accomplishments, Accolades, Awards, etc.

List Other High Schools (if applicable) in Bullet form with Sports, Yrs, Awards Example: • 2002-2003: West Side High, Phoenix, AZ, USA • 2002 Football, Varsity, Tight End • 2003 Football, Varsity, Tight End, Team won AZ State Championship, I was voted All State, and MVP.
High School Club Rugby History (If Applicable)

Name of High School Rugby Club (If different from High School).

Location of High School Rugby Club

Enter last year (YYYY) the Nominee played HS Club Rugby.

Enter the year (YYYY) that the Nominee started playing HS Club Rugby.

List the Nominee’s Primary Position whilst playing HS Club Rugby

List the Nominee’s HS Club Rugby Yrs, Accomplishments, Accolades. Provide a Bulleted List of Yrs, Positions, Accomplishments and Awards. If there are multiple Clubs list these Clubs and Locations.

Page 3

College(s)/University(ies) - Years, Accolades/Awards:


















Page 4

Club Rugby - Years, Accolades/Awards:


Enter Name of the first Club.


















Page 5

USA Rugby (Eagle 15s) - Years, Accolades/Awards:


Did the Nominee play for the USA Eagles 15 team? If "Yes", fill in the questions in this section. If "No", this section is NA (or "Not Applicable"), the questions will not appear, and you can skip to next section.
USA Rugby (Eagle Fifteens) Playing Summary






Eagle 15 Test A



Page 6

Hide Section - USA Rugby (Eagle Sevens) - Years, Accolades/Awards:

USA Rugby (Eagle Sevens) - Years, Accolades/Awards:


Did the Nominee play for the USA Eagles 7s team? If "Yes", fill in the questions in this section. If "No", this section is NA (or "Not Applicable"), the questions will not appear, and you can skip to next section.
USA Rugby (Eagle Sevens) Playing Summary











Page 7

Representative Team(s) – Years, Accolades/Awards:


Representative Team 01 Information







Representative Team 02 Information







Representative Team 03 Information







Representative Team (Others) Information

Page 8

Professional Team(s) – Years, Accolades/Awards:


Professional Team History













Page 9

Coaching (if applicable) – Years, Records, Significant Accomplishments:


Rugby Coaching History
























Page 10

Hide Section - Refereeing (if applicable) – Years, Records, Significant Accomplishments:

Referee and Referee Administration Experience (if applicable) – Years, Records, Significant Accomplishments:


Nominee Referee and Referee Administration History






























Page 11

Hide Section - Media (if applicable) – Organization(s), Years, Role(s), Accomplishments:

Media (if applicable) – Organization(s), Years, Role(s), Accomplishments


Media Role 01 Description and Information





Media Role 02 Description and Information





Media Role 03 Description and Information





Media Role 04 Description and Information






Page 12

Administration (if applicable) Organization(s), Years, Role(s), Accomplishments


Administration Role 01 Information





Administration Role 02 Information





Administration Role 03 Information





Administration Role 04 Information






Page 13

Medical (if applicable) - Organization(s), Years, Role(s), Accomplishments


General Medical Information




Medical Role 01 Information





Medical Role 02 Information






Page 14

Nomination Summary Information

  • Other Relevant Information
  • Written Summary Paragraph
  • Nominator Information
  • Letter of Support Information
  • Pictures
  • Video
Other Relevant Information

Enter any relevant information that does not fit into the other categories on the Nominee Form.
Written Summary of Nominee Application by Nominator

Enter a Summary of the reasons that the Nominee deserves to be in the US Rugby Hall of Fame. The Summary may not exceed 5,000 characters.
Nominator Information




Letters of Support for the Application (Optional)
Letter of Support Provider 01





Letter of Support Provider 02





Letter of Support Provider 03





Pictures

Add picture taken during playing days. The picture should be in JPG or PNG format. (10 MB max size)

Add a recent picture. The picture should be face and torso. The picture should be in JPG or PNG format. (10 MB max size)
Video

Optional: Please Upload a Video of the Nominee. (35MB Max. Size)