Nominations being accepted for 2013
Clinton High School Wall of Fame
Nomination for year 20_______
Nominee's Name ___________________________________________________________________
Nominee's Current Address: Number/Street ___________________________________________
City ________________________ State ___________________ Zip code ____________
Phone numbers: (Home) (_____)_______________ Work (_____)___________________
Category of nominee: (Please circle one)
Alumnus Honorary
Graduation Year (Alumnus must have graduated 10 years prior to nomination) ___________
If the nominee is deceased, please provide data for the surviving spouse or next of kin:
Name of survivor: ____________________________________________________
Address: ____________________________________________________
____________________________________________________
Post High School Education: (Training, University, degrees, dates):
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In the following areas, please feel free to attach additional information.
What contributions has the nominee made to the spirit and values of Clinton High School? (Modeling high standards of excellence in personal life)
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What noteworthy professional contributions has the nominee made? (Contributed to profession beyond normal requirements and expectations. Received professional awards or recognition. Publications.)
______________________________________________________________________________
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What contributions to the community has the nominee made through community service or volunteer work? (Public office, Board of Directors, Other offices held, etc.)
______________________________________________________________________________
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Other information you feel is pertinent to the nomination:
______________________________________________________________________________
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Name of person making nomination: _________________________________________
Address: _________________________________________
_________________________________________
Phone/Fax : _________________________________________
E-mail: _____________________________________________
Today's date:_________________________________________
Please send completed nomination form and all attachments to:
| Wall of Fame |
| Clinton High School |
| Mr. Eric Snider, Principal |
| 425 Dragon Drive |
| Clinton, TN 37716 |
Deadline for submission: September 15, 2013
