Hall of Fame Nomination Form

Public Safety Hall of Fame Nomination Form

Attachment Checklist:

• Summary of nominee’s professional public safety history.  (Required)
• Description of why nominee should be selected (include description of their contributions to public safety).  (Required)
• Agency/Department photo.  (Required)
• Proof of nominee’s outstanding performance, actions, accomplishments, and character (e.g. any professional acts of excellence above and beyond minimum standards). Examples include letters of recommendation, official reports, statements, newspaper article(s), and/or other media archive historical references.
• Summary of civic contributions and/or humanitarian activities. Describe as completely as possible, the nominee’s local, state and national level of service in civic organizations. Include information about community involvement in public safety, charitable activities, etc. Also describe as completely as possible the nominee’s contributions in any humanitarian service.  (Required)
• List of awards and honors.  (Required)

NOTE: Only nominator will be contacted if the nominee is not selected.  Nominee and nominator will be contacted if nominee is selected to be inducted.