Richland One Hall of Fame 2023 Nomination Form
Full Name of Nominee
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First Name
Last Name
Is the nominee living or deceased?
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Living
Deceased
Is the nominee a Richland One graduate?
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Yes
No
If yes, which Richland One schools did nominee attend?
High school and graduation year (If known):
Nominee's Address (If applicable)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Nominee's Phone Number
*
Nominator (Your Name):*
*
First Name
Last Name
Nominator's address (Your address):
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Preferred phone number (Your phone number):
*
E-mail Address (Your email address):
*
example@example.com
I certify that the information provided in this nomination is complete and accurate to the best of my knowledge and I have notified the nominee or his/her family of the nomination.*
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Yes
No
Your Signature:
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Today's Date:
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-
Month
-
Day
Year
Date
SECTION 2: NOMINEE’S RELATIONSHIP TO RICHLAND ONE (0-10 Points)Please provide specific, detailed information written with the assumption that the persons who will review your nomination will not have any prior knowledge of your nominee. Please limit your statement to 300 words or less. Provide describe in detail the nominee’s relationship to Richland One as a former student, former employee, former school board member, parent, volunteer/partner, community leader or other connection to the district.
*
SECTION 3: CONTRIBUTIONS TO RICHLAND ONE (0-25 Points) Please provide specific, detailed information written with the assumption that the persons who will review your nomination will not have any prior knowledge of your nominee. Please limit your statement to 300 words or less. Describe in detail the contributions (tangible, intangible, financial and/or in-kind) the nominee has made to Richland One.
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SECTION 4: DIRECT IMPACT ON RICHLAND ONE (0-30 Points) Please provide specific, detailed information written with the assumption that the persons who will review your nomination will not have any prior knowledge of your nominee. Please limit your statement to 300 words or less. Describe in detail the direct impact the nominee’s dedication and commitment have or have had on Richland One and how the results have added to the quality of education or enhanced the educational environment and/or services in Richland One.
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SECTION 5: PROFESSIONAL AND VOLUNTEER CONTRIBUTIONS (0-20 Points) Please provide specific, detailed information written with the assumption that the persons who will review your nomination will not have any prior knowledge of your nominee. Please limit your statement to 300 words or less. Describe in detail how the nominee has contributed to his/her profession, community and/or society as a whole, beyond his/her contributions to Richland One.
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SECTION 6: HONORS AND ACHIEVEMENTS (0-15 Points) Please provide specific, detailed information written with the assumption that the persons who will review your nomination will not have any prior knowledge of your nominee. Please limit your statement to 300 words or less. Provide details about the nominee’s educational, professional and/or volunteer honors and achievements.*
*
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