Historical Society Award Nomination Form
Submit your nomination for an individual, group, or organization for the Historical Society Award. Please provide detailed and accurate information to support your nomination.
Nominee Type
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Individual
Group
Organization
Nominee Name
*
Nominee Affiliation or Organization (if applicable)
Award Category
*
Please Select
Lifetime Achievement
Outstanding Contribution
Emerging Leader
Community Impact
Preservation Efforts
Other
Please describe the nominee's achievements or contributions
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How has the nominee impacted historical preservation or awareness?
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Nominator's Full Name
*
First Name
Last Name
Nominator's Email Address
*
example@example.com
Nominator's Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Additional Comments or Supporting Information
Submit Nomination
Should be Empty: