The Dayton Theatre Hall of Fame

DAYTON THEATRE HALL OF FAME NOMINATION FORM

* - denotes required entry

Nominee Information

Name:		*
Address:		*
City:
State:
Zip:
Phone:		*
e-mail:

Nominator Information
Name:		*
Address:
City:
State:
Zip:
Phone:		*
e-mail:		*

1. Tell us about the nominee.

Please provide as much detail as possible. Include information such as:

Years of service to Dayton theatre
Years of Activity (teaching, acting, directing, technical, etc.)
Theatre experience with Dates, Theatre and Position

(note: all of the text boxes on this page will expand for large entries)

2. Career description.

Provide a description of the nominee’s work as a theatre artist or supporter of theatre in Dayton, Ohio. Include examples of his/her dedication to theatre arts and his/her efforts to improve quality theatre in Dayton.

3. Involvement

Please describe this person’s involvement in other arts organizations.

4. Narrative

Using the space below, explain why you believe the nominee should be honored by induction into the Theatre Hall of Fame.

5. References

Please provide the names and contact information for two references who can provide additional information to support your nomination. References may not include the person submitting this nomination.

First Reference
Name:		*
Position/Title:
Relationship to Nominee:
Phone:		*
e-mail:		*

Second Reference
Name:		*
Position/Title:
Relationship to Nominee:
Phone:		*
e-mail:		*