DUSTOFF ASSOCIATION

P.O. Box 8091, Wainwright Station, San Antonio, TX 78208

 

DUSTOFF HALL OF FAME NOMINATION FORM
(THE INDUCTIONS WILL TAKE PLACE AT THE DUSTOFF ANNUAL REUNION)

 

 

1.     _________________________________________________________________________________________________

        Name of the Nominee                                                                                                                      

 

        _________________________________________________________________________________________________

      Address of the Nominee

 

        _________________________________________________________________________________________________

        City                                                                                                           State                                                             ZIP

 

        _________________________________________________________________________________________________

        Nominee's Phone Number              Nominee’s Fax Number                  Nominee’s E-Mail Address

 

2.     _________________________________________________________________________________________________

        Name of Nominator                                                                                                                                        Date

 

        _________________________________________________________________________________________________

      Address of the Nominator

 

        _________________________________________________________________________________________________

        City                                                                                                            State                                                            ZIP

 

        _________________________________________________________________________________________________

        Nominator's Phone Number           Nominator’s Fax Number                     Nominator’s E-Mail Address

 

 

3.     Main reason for the nomination (160-word summary) ________________________________________________________

 

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RETURN THIS COVER SHEET WITH UP TO  1,200 WORDS DOCUMENTING THE ACCOMPLISHMENTS OF THE INDIVIDUAL NOMINEE AND A COLOR PHOTO OF ANY SIZE TO:

DUSTOFF Association, ATTN: Hall of Fame, PO Box 8091, San Antonio, TX 78208 ON OR BEFORE MAY 1. All forms may be converted to digital format and submitted electronically to executivedirector@dustoff.org .