Benjamin F. Dillingham, III & Bridget Wilson LGBT Veterans Wall of Honor Nomination Form
Please submit this form and all backup information by Friday, July 31, 2020 for induction consideration this year.
Email address *
This section is for information about the person being nominated.
Nominee's Full Name *
Your answer
Branch of Service *
Years in service *
For example: 1975-1979
Your answer
Type of discharge *
Your answer
Time lived in or served in San Diego *
Your answer
Best description of ethnic identity *
Your answer
Best description of gender identity *
Your answer
Best description of sexual orientation *
Your answer
Pronouns *
For example: she/her/hers, they/them/theirs
Your answer
Is candidate living or deceased? *
Candidate phone number *
If they are deceased mark n/a.
Your answer
Candidate e-mail address *
If they are deceased mark n/a.
Your answer
This next section is asking information about the person submitting this nomination form.
Name of nominating individual *
Your answer
Relationship to nominee
Your phone number *
Your answer
Please describe how the nominee meets the nomination requirements (which are listed here: https://thecentersd.org/about/wall-of-honor/lgbt-veteran-wall/veterans-candidate-criteria/). Please write this section as if the committee knows nothing about the candidate, and use detail to describe the candidate's contributions to the community. If desired, you may type the response to this section in a separate word processor like Word and paste it here.
Your answer
Please list two additional San Diego residents who will serve as co-sponsors of this application including: full name, phone number, and email. *
Your answer
Nomination check-list
Items that are separate from this online application (ie. nomination statement, co-sponsor signatures, DD214, etc) should be sent in separately by July 31, 2020 via e-mail to hweldeghiorgis@thecentersd.org or post mail to:
The Center
c/o Helen Weldeghiorgis
PO Box 3357
San Diego, CA 92163
Please check-off items you have completed/submitted.
If you are not submitting any piece of the required documentation from the nomination check-list, please note the reason below.
Your answer
A copy of your responses will be emailed to the address you provided.
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