Preservation Salem County, Incorporated
2009 Award Nomination Form
The second annual PSCI Awards Dinner on Saturday, September 26th
at Salem City Cafe in Salem will honor individuals or organizations
that have made significant contributions
to the preservation of Salem County architecture, culture, history or land.
ANY county resident may nominate ANY county person or organization for this honor.
Please type or neatly print the required information.
The completed form and all supporting documentation must be sent to:
Preservation Salem County, Inc.
PO Box 693, Salem, NJ 08079
OR
info@preservationsalem.org
by September 16th.
NOMINEE __________________________________________________________
Name (Person or Organization) Phone #
_________________________________________________________________
Complete Mailing Address E-mail Address
__________________________________________________________________
City/Town State Zip
NOMINATOR ______________________________________________________
Name Phone #
__________________________________________________________________
Address City/Town Zip
E-mail address
On separate sheets, fully describe the contributions on which the nomination is based. Give dates of activities, final results of activities and impact on preservation in Salem County. Photographs and previously published articles may also be submitted as part of the nomination.