Preservation Award Nomination
Year 2009
Structure Address: _________________________________________________________ Year Built __________
Residence _________ Business _________
Owner _______________________ Telephone ______________________ Fax __________________
Address __________________________________________________________ E-mail __________________
House Name ___________________________________ Builder _______________________________
Category: Restoration __________ Preservation __________ Adaptive Reuse __________ Other __________
Historical Narrative/Exterior Photograph (Please Attach)
Will owner speak at Awards Ceremony? Yes ______ No ______
Other Comments: _______________________________________________________________________________
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For League Use Only:
Previous Award Yes ____ No _______ History File # _________ Evaluation Date: _____

Comments:___________________________________________________________________________________________
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If you would like to nominate a property, please mail the nomination form to the address at the bottom of the page.

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