Washington Conservation SocietyCREATING a Legacy Nomination Application

Your Name

Your Email Address

Name of Person Nominated for Induction*

Conservation District or Organization this person served

Conservation Efforts

Please provide a brief written description below of how this person served the

conservation effort in Washington State:

Please email a photograph of the nominee to: heather-www.waconservationsociety.org

If you would like to include a memorial gift in honor of this person, please mail it with a copy of the application to:

Washington Conservation Society

C/O WACD

16564 Bradley Road

Bow, WA 98232

Send me a copy of my responses