Roll of Honor Nomination

/ Forest Service Museum Honor Roll
National Museum of Forest Service History / P.O. Box 2772
Missoula, Montana
59806-2772
406-541-6374

A Non profit Corporation

Forest Service Museum Honor Roll Nomination

For a one-time donation of $100 or more, the National Museum of Forest Service History recognizes those who have contributed to the mission of the Forest Service. Anyone is eligible, including current, former and retired employees of the Forest Service, and people or groups whose work has supported the Forest Service mission. The Honor Roll can also commemorate special events in Forest Service history.

A Memorial Grove on the National Conservation Legacy and Education Center grounds in Missoula honors everyone who has contributed to the mission of the Forest Service. Honorees are recognized in anHonor Roll book and on the Museum’s web site.

Nominations are subject to approval. Please contact the Museum if you have any questions.

Please provide the following information and add additional sheets as needed:

Date of Nomination:______

Honoree:

Name:______Phone: ______

Address: ______City: ______State:_____Zip:______

Email: ______

Date of Birth:______Date of Death (if applicable): ______

Category:

□ Former/Current Forest Service Employee□ Group

□ Volunteer/Partner/Supporter□ Event

Date(s) of Service:

Date / Location: Ranger Districts, National Forests, Regions, or Stations as appropriate / Position
/ Forest Service Museum Honor Roll
National Museum of Forest Service History / P.O. Box 2772
Missoula, Montana
59806-2772
406-541-6374

A Non profit Corporation

Brief Biography: (Please email to if possible)

Please submita separate sheet for biography narrative, including those items or events that illustrate the Nominee’s contribution to the Forest Service mission.

Please submit Photo(s) of Nominee with date and location, electronically if possible.

Name of person completing nomination form:

Name:______Phone: ______

Address: ______City: ______State:_____Zip:______

Email: ______

Donation ($100 or more):$______Please mail a check or pay by credit card:

Name On Card:______

Type of card (please circle): Master Card Visa American Express Discover

Credit Card Number: ______

Expiration Date: ______/ ______CVV # (3 digit code on the back of the card): ______

Zip code of credit card billing address: ______

Please submit all information electronically if possible, to:

The NMFSH is a 501(c)(3) nonprofit corporation and all donations are deductible from the donor's federally taxable income as described in the Internal Revenue Code.NMFSH compilations of personal tributes and historical recollections are the property of the NMFSH and may not be reproduced or distributed in any form without express written permission of the NMFSH.