NEA-New Mexico Hall of Fame Nominations

Region*
Years Retired (2 minimum)*
Name of Nominee*

First NameLast Name
Title or Position*
Nominee's Personal (non-school) Email*
example@example.com
Nominee's Mobile Number*
Please enter a valid phone number.
Nominee's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Number of Years as Member*
Nominee's Leadership Positions (Local, State, National) including Professional and Civic positions held*
Attach documents below, if needed
Nominated by*
Date

MonthDayYear
Date
Nominator Personal (non-school) Email *
example@example.com
Nominator's Mobile Number *
Please enter a valid phone number.
The nominator must address the nominee's specific service to these four areas in the one-page statement of worthiness
1. Association
2. Education
3. Students
4. Community
Required Documentation:
- 1-3 letters of support
- Up to 3 pages of supporting documentation (optional, refer to award guidlines on NEA-NM's website, neanm.org)
If you have any questions about completing this form, you may contact Elizabeth Martinez at emartinez@neanm.org or 505-986-2855.
Three Letters of Support*

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Should be Empty: