Preservation Alliance of La Crosse, Inc. - Heritage Award Nomination

 
Date: _____________________

Nominee:
 
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Name
 
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Address
 
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City, State, Zip
 
(________)_____________________
Phone
 

Nomination Submitted By:
 
_____________________________________________________________________
Name
 
_____________________________________________________________________
Address
 
_____________________________________________________________________
City, State, Zip
 
(________)_____________________
Phone
 
______________________________________________________________
E-mail Address

Category: (check one)
Eligibility may be for interior only, exterior only, entire structure, building complex, site or remnants.
_____ Residential restoration or rehabilitation
_____ Non-residential restoration or rehabilitation
_____ Historic landscape or archaeology
_____ Individual Distinguished Service Award

Description:
Briefly describe the project, program, or activity. Please include pictures, clippings, booklets, and/or a biography of the individual you are nominating.  Note: Send copies only.  Materials you send will not be returned to you.
 
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Please send this form along with copies of any supporting documents to:

Nominations must be received by April 10 to be considered for the current year's awards.