Ac Hallof Fame App RTF by X968vhZ

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									                      Medford Area Senior High
              Alumni Hall of Fame Application

Complete the following pertinent information and attach this sheet to the nomination letter.
Return completed application to Mrs. Jill Lybert, High School Principal, Medford Area Senior
High, 1015 W. Broadway, Medford, Wisconsin, 54451 or fax it to 715.748.6438


Name of Nominee:
Address of Nominee:


Email:
Telephone:
Year of Graduation from Medford Area Senior High:


Name of Nominating Person:
Address:


Email:
Phone Number:


Signature:
Date:

								
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