Nominee's Information

Nomination Categories:

Are you nominating an Individual or Group?

Year of Graduation or Retirement from NPS:

Is this a posthumous nomination?

Yes

No

Unsure

Nominee's Profession:

Accomplishments of the Nominee (Awards, Service, Volunteerism, Organizations, Honors, Etcetera):

Why should this person be inducted into the NPS Hall of Fame?

How do they embody the mission of NPS?

Please complete as much contact information for the nominee as possible. If a relative should be notified instead, please fill out their information. We understand in some situations you may not have access to this information or it may be irrelevant, but we appreciate whatever information you are able to provide. Thank you!

Contact Information Is For:

Nominee

Relative

Other

Nominee's Mailing Address:

Address Line 1

Address Line 2

City

State/Region

ZIP/Postal Code

Nominee's Email Address:

Nominee's Phone Number (If unknown, type 402-555-1212):

Nominator (Your) Information

Nominator's First Name:

Nominator's Last Name:

Nominator's Email

Nominator's Phone Number: