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Malden High Hall of Fame nomination form

MALDEN HIGH SCHOOL ALUMNI ASSOCIATION

HALL OF FAME NOMINATION FORM

1. Information about the person you are nominating (please print or type):

First Name --------------------------------------------------------------

Last Name ---------------------------------------------------------------

Year of Graduation from MHS --------------------------------------

Current Address --------------------------------------------------------

Email Address------------------------------------------------------------

Telephone Number -----------------------------------------------------

2. Category of Nomination (please check one)

Arts ------------------------------------------------------------------------

Business-------------------------------------------------------------------

Community Service ----------------------------------------------------

Education ----------------------------------------------------------------

Government -------------------------------------------------------------

Media----------------------------------------------------------------------

Military-------------------------------------------------------------------

3. Outstanding Achievements - (please list) _________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

_________________________________________________________

4. Qualifications - To assist the Hall of Fame Selection Committee in their decision-making, please attach a brief narrative (one page or less) that expands on the

specific qualities and qualifications of this nominee.

5. Name of person making the nomination:

First Name -----------------------Last name-----------------------------------

Current address-----------------------------------------------------------------

-------------------------------------------------------------------

Best telephone number --------------------------------------------------------

Email address if applicable---------------------------------------------------

Nomination forms may be mailed to MHSAA, P.O. Box 47, Malden, MA. 02148,

or they may be emailed to Joanne Iovino at jli4671@yahoo.com or

Diane Lind at dlind420@verizon.net .

ALL NOMINATION FORMS MUST BE RECEIVED BY JANUARY 24, 2014.


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