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Nomination Form

Only nominations received utilizing this form will be accepted as a nomination to the GLBT  Hall Of Fame. In cases where you wish to snail mail your nomination, print this form and use as a guide and include with your written or typed nomination. Send to:

StoneWall Society Network / GLBT Hall Of Fame
POB 11135
Charleston, West Virginia 25339

The completion of information in all fields is necessary to assist in verifying the nominations. In areas where the information/field is marked required by an asterisk, (*), if the information is omitted the entire nomination may be discarded. If you do not have the information requested please state, in the appropriate field why not. For security purposes your email address will be required twice below. An invalid email address will constitute disqualification of the nomination. You will receive a confirmation of nomination receipt email. We may contact you for additional information regarding your nomination.

Enter your email address in the box below and later in the form. 
Email addresses must match and be valid operational email accounts.
 

Please provide the following contact information for yourself, the person making the nomination: * indicates a required field for nomination consideration.

First Name
Last Name
Organization
E-mail*
URL

Please state the name, city, and if known, contact point for your nomination.*


Please state an overall description for the reason of your nomination.*


Please list specific events, achievements, and or impacts which qualify your nomination for inclusion to the GLBT  Hall Of Fame.*


Please list any URL's or printed information which substantiate your nomination.


Please list the names email and or snail mail contact points for three separate contacts who may verify your nomination claims. This is very helpful for localized nominations where large amounts of documentation are not available. (This is optional. However, if we cannot substantiate claims made in a nomination it is likely the candidate will not be accepted.


Are you personally involved with your nomination? This will not disqualify the nominee. Only a lack of reason will disqualify. We ask this to better understand the environment of the nomination and those nominating.*


By checking one of the options below you affirm the checked option that;*

The information I have submitted is true and accurate.
The information I submitted I believe to be true and accurate.
The information I have submitted I have heard but cannot verify.

If we don't honor and remember who will?

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2004 - 2008 GLBT  Hall Of Fame