Bethlehem Central High School Hall of Fame Nomination Form

Bethlehem Central High School Hall of Fame Nomination Form
Your Name

First Name Last Name
Your Phone Number

Area Code Phone Number
Your E-mail Address
Your Mailing Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Nominee's Name

First Name Last Name
Nominee's Phone Number

Area Code Phone Number
Nominee's E-mail Address
Nominee's Mailing Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
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: