Jefferson High School Alumni Hall of Fame Nomination Form

We are now accepting nominations for potential candidates into the Jefferson High School Alumni Hall of Fame.
Nominations may be made by alumni, parents, current Jefferson students, faculty, staff, administrators, and citizens from our community. In order to judge all nominees equally, please use only the following form. Attachments will not be accepted. This nomination packet will be kept on file for a period of three (3) years. If your nominee is not selected, you are encouraged to resubmit with updated information.

Please help us publicize this project by informing your friends, associates and others who are qualified to submit nominations. Nomination packets are available at Jefferson High School.

Criteria to be considered:
Nominee Information
Name of Nominee:

Year of Graduation:

Address:

City:

State:   Zip:

Phone:

Nominator Information
Name of Nominee:

Address:

City:

State:   Zip:

Phone:

Narrative
Why do you think this nominee should be a member of the Jefferson High School Hall of Fame? Use this space to summarize your thoughts and feelings. Specific accomplishments can be listed on the appropriate page. This is your chance to explain why you selected this individual for nomination.

Specific Recognition and Achievement Information
What specific achievements or recognition has this nominee received?

Community Service
List specific evidence of involvement in community service. Please include dates if known.

Honors/Awards

List individual awards or honors received by this nominee. Please include dates if known.

Please hit the submit button only once

If you are using AOL, you cannot use the SUBMIT button at the bottom of the form. You will need to copy the text from this form and paste it into a new email message. You will then be able to enter text at the appropriate places. Email should be addressed and sent to mhodge@lsc.k12.in.us

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