Nomination Form - National Cowboy & Western Heritage Museum

Criteria of individuals will be selected following careful evaluation of the following:
Significant contributions by a performer, living or deceased, to the perpetuation of Western entertainment media.
Outstanding career achievement, including but not limited to performances in five productions.
Nominee projects the traditional Western ideals of honesty, integrity and self-sufficiency in career endeavors over a lifetime.
The Board of Directors of the National Cowboy & Western Heritage Museum may consider an outstanding ensemble production to receive a Special Directors’ Award.

Nominee Name(Required)

First Last

Address (if living)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email(Required)

Phone(Required)

Contact Information for Submitter(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email(Required)

Phone(Required)

List of Significant Recognition or Awards(Required)

Indicate each award or accomplishment on a new line. Use the plus sign to add a new line

Filmography or Stage Credits(Required)

Indicate each credit on a new line. Use the plus sign to add a new line

Character Comments

If Nominee is living, would he/she commit to attending the ceremony?

Photograph & Letters of Recommendation(Required)

Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 20 MB, Max. files: 6.

Maximum of 5 Letters of Recommendation. Image of nominee needs to be in a jpg format and any letters of recommendation need to be in pdf format

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