15th YWCA Northwest Women's Hall of Fame Nomination Form
NOMINATIONS ARE DUE BY FEBRUARY 1, 2013

Please supply the following information:
1)Name and complete contact information for the nominee (if deceased, the date of death, if known)
2)Your name and complete contact information
3)Examples of how the nominee has made a lasting impact, promoted opportunities or served as a role model for women and girls, demonstrated perseverance and vision, and – if applicable – overcome obstacles to achieve her goals.
4)(Optional) Names and contact information for others who support the nomination.

For additional information, including names of previous honorees, see http://ywcabellingham.org/nww-hall-of-fame/, e-mail karen@ywcabellingham.org or call (360) 734-4820.

*Please note that nominations can be made throughout the year, are retained for 3 years, and no serving member of the YWCA staff, YWCA Board of Directors or the NW Women’s Hall of Fame Steering Committee is eligible to nominate or be selected.
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Nominee Information:
Name
Date of Passing
(If deceased)
Mailing address
Telephone
E-mail
Your Information:
Name
Mailing Address
Best Telephone Contact
(Work, Home, Cell)
E-mail
Please Type Responses to the Following Questions:
(Be as specific as possible about her contribution, providing names of organizations or activities in which she was active and the approximate dates of her involvement.  Mention of additional community service is also helpful, as are quotes from people who best know her contributions. There is no word limit to your responses. The selection committee needs complete information to make informed decisions.)
1. What has she accomplished of lasting significance?
2. How has she promoted opportunities for women or been a role model for women and girls?
3. How has she overcome obstacles and demonstrated perserverance and vision?
4. Assume the selection committee knows nothing about the nominee. Tell her story giving the most information you can in a few sentences.
Name, telephone and e-mail of other nomination supporters.
(Optional)
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