FMS Hall of Fame Nomination form

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Hall of Fame Nomination Form

1. Name of Nominee or Organization _____________________________________________________________

2. Is the Nominee living or deceased?  Living  Deceased

3. Contact Information for Nominee (Email, phone number, mailing address)

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4. Name of Nominator & FMS membership number _________________________________________________

5. Contact Information for Nominator (Email, phone number, mailing address)

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6. Describe the Major Contribution of Nominee (Refer to the Selection Criteria in Section B4.2.3.4 of By-Law

B4.2.3: The Fluorescent Mineral Society Hall of Fame for guidance, or see over). Include dates in which those

contributions took place. (Use additional space if necessary.). Please Attach Supporting Documentation and

Photos.

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7. In what other area or areas (e.g., Research Outreach, Technological, Education, Contributions, Service to the

FMS, Other) has the Nominee made significant contributions. Describe.

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__________________________________________ ___________________________________________

Signature & FMS Member Number Signature & FMS Member Number

of Supporting Member of Supporting Member

__________________________________________ __________________________

Signature & FMS Number of Nominator Date of submission

The Fluorescent Mineral Society

P.O. Box 572694, Tarzana, California, 91357-2694

www.uvminerals.org

Form

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