[revised August 2008]

Nomination Form

(Please Print)

1. Name of Nominee____________________________________   Date____________

2. Address______________________________  City________________  Zip_______

3. County_________________  Phone__________________  E-mail_______________

4. Name of Nominating Organization_________________________________________

5. Name of Nominating Person _______________________________________

    Address______________________________ City_______________Zip__________

    Phone________________   E-mail________________________________

6. Category Nominated For:  ___ Outdoorsperson – Volunteer         

____Media Professional     ____Outdoor Professional

 *Since the emphasis or consideration will be given to items number 7 and 8 below, please attach separate sheets listing and explaining the information asked for.

7. List Specific Achievements for Conservation and Youth Education:

8. List achievements or contributions that the Nominee has given back for future generations or preserving our outdoor heritage and outdoor sports:

   ** Please attach any documentation, including reference letters that you feel necessary and pertinent to the nomination.

Check the web site www.nysohof.org for information or contact numbers.