Nomination Form The nomination deadline this year is November 1, 2017. A PDF document mail-in version is available HERE Arkansas Agriculture Hall Of Fame Award Nomination First Name: Middle Initial: Last Name: Email: Current Mailing Address (Living): Last Residence (Deceased): Phone Number: Fax Number: Nominee’s primary position and affiliation: Phone Number.: Fax Number.: Email.: Date of Birth: Place of Birth: Include City, State, and County Nominee’s Education (list all degrees earned, dates, major fields, and institutions): Provide a brief summary of nominee’s contribution to agriculture, community economic development. Please attach any newspaper clippings, documents or other supporting materials Acceptable file types: doc,docx,pdf,txt,gif,jpg,jpeg,png.Maximum file size: 4mb. Provide record of professional experience (principal positions held, primary responsibilities for each position, dates): List activities and other noteworthy pertinent accomplishments in public service (boards, committees, consultantships, civic activities, service activities, important offices held and other contributions to society): Detail professional recognitions (honors, awards, prizes, honorary degrees, etc., give name of institution and date): What is the principal justification for receipt of the award? Nominator: Relationship to the Nominee: Nominator Address: Nominator Phone Number: Nominator Email: Please Note: For posthumous nominations, please include date of death and pertinent contact information for whomever will function as the principal support person in facilitating the nomination and possible induction.