DUSTOFF
ASSOCIATION
P.O. Box 8091,
Wainwright Station, San Antonio, TX 78208
DUSTOFF HALL OF FAME NOMINATION FORM
1. _________________________________________________________________________________________________
Name of the Nominee
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Address of the Nominee
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City State ZIP
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Nominee's Phone Number Nominee’s Fax Number Nominee’s E-Mail Address
2. _________________________________________________________________________________________________
Name of Nominator Date
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Address of the Nominator
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City State ZIP
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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.