COUNTRY MUSIC SHOWCASE INTERNATIONAL, INC.
Iowa Nonprofit Org. #135465

IOWA/MIDWEST “VIRTUAL” COUNTRY MUSIC HERITAGE
MUSEUM, LIBRARY, HALL OF FAME

******* PLEASE PRINT OUT THIS OFFICIAL FREE FORM ******

OFFICIAL  “HALL OF FAME” NOMINATION FORM

_____INDIVIDUAL     _____ BUSINESS    _____ORGANIZATION

(Put A Check Mark By One, Two Or All Three Of The Above  Categories For Nominee To Be Under)

BASIC REQUIREMENTS FOR  NOMINATION/INDUCTION  INTO THIS HALL
OF FAME  ARE LISTED BELOW:


SIGNIFICANT Contributor To The Preservation Of Any Country Music Art Form!

BORN In Or Citizen Of The United States Of America

 YOUR NOMINEE:
(
CIRCLE ALL That Is Applicable To Your Nominee Basic
Requirement For Induction into this Hall Of Fame)

Singer | Songwriter | Musician | Entertainer | Recording Artist | Arranger |

Producer | TV Personality | Radio (DJ) Personality | Audio Engineer |

 other_____________________________________________________
 

 I would like to NOMINATE:_________________________________________________
  For INDUCTION Into The Iowa Midwest Country Music Heritage Hall Of Fame.

(If Living) Their Address:__________________________________________________

City:______________________________________ State_______Zip_____________

Ph. (              ) __________  ________________e-m:___________________________

(If Deceased/ Internment Site)_______________________________________________

Please Use The Back Side Of This Nomination Form To List All Music Contributions And Achievements. Include Any Photos You Would Want To Be Used.
*************************************************************

 The PERSON Providing The Above Information Please Fill Out Section Below. (Please Print)

Name______________________________________________________________

Title: (Circle One) Wife | Friend | Associate | Other:_____________________________

Address:_____________________________________________________________

City:_______________________________________State________Zip___________

Ph.(              )  __________   ___________________e-m_______________________

Your Web Site: http://___________________________________________________

Person Making Nomination - Are You Involved The Country Music Business  YES  |  NO

If So, How:____________________________________________________________

_____________________________________________________________________

 

Return This Form To:

 Harold Luick, CEO, Historian, Curator
Hall Of Fame Nomination
 P.O. Box #368
 Carlisle, Iowa   50047-0368
515-989-3748

e-mail:  museum@cmshowcase.org
Web Site:  http://www.cmshowcase.org

****
To donate to the museum send payment through Pay Pal using
donations@cmshowcase.org as the payee address

You Do Not Have To Be A Member Of CMSI To Nominate Some One!  
This Form Is © 1984 CMSI All Rights Of Use Reserved.

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