Bethlehem Central High School Hall of Fame Nomination Form

Bethlehem Central High School Hall of Fame Nomination Form
Your Name

First NameLast Name
Your Phone Number

Area CodePhone Number
Your E-mail Address
Your Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Nominee's Name

First NameLast Name
Nominee's Phone Number

Area CodePhone Number
Nominee's E-mail Address
Nominee's Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
BCHS Graduating Class of
Description of Nominee's educational background (if known) (universities, colleges, degrees, awards, etc.):
Description of Nominee's career accomplishments:
How does the Nominee embody the mission statement of Bethlehem Central (Knowledge, Character, Value):
Description if the Nominee's achievements (awards, honors, prizes, publications, appointments, volunteer work, etc.):
Should be Empty: