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Nominee
First Name
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M.I.
Maiden Name
Last Name
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Suffix
High School
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Please Select…
LM - Lincoln
LM - LMHS
TC - Wolvin
TC - Central
TC - Booker T. Washington
TC - TCHS
Class Year
The year the nominee graduated from high school
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Address 2
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Country
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Phone (Work)
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Nominator
First Name
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M.I.
Maiden Name
Last Name
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Suffix
Address 1
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Address 2
City
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State
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Zip
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Country
Phone (Home)
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Phone (Work)
Email
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Nomination Date
(mm/dd/yyyy)
A letter of recommendation must be attached to this nomination. If available, a photograph of the nominee would be appreciated. Letters and nominee information may be included in the text box below or attached to this submission. Letters and nominee information may be a maximum of three pages (front and back). Any information that surpasses the three pages will not be considered.
Nominee's qualifications or reason for induction
Letter of Recommendation
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Photograph
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