Candidate Information Section CANDIDATE NAME: Is your candidate still alive? YesNo Address: City: State: Zip: CANDIDATE TELEPHONE CANDIDATE EMAIL CANDIDATE HISTORY What category or categories does your candidate fall under? (You may select more than one) Accomplishments / ContributionsDevelopmentEd Yost Master Pilot AwardHall of FameMontgolfier Ballooning DiplomaPast PresidentsRecordsShields Trauger AwardUnited States Hall of Fame MemberUnited States or World Record HoldersOther Please give us a little more information on why you chose Other. Tell us about your Balloonist. Please give as much history as you can. You will be able to attach files below. (You may copy and paste in this box or attach files below.) Include a picture of the balloonist, other appropriate ballooning pictures and other files that contribute to the biography. You may attach the following file types. (gif, jpg, jpeg, tif, png, doc, docx, pdf, xlsx.) Please keep files under 2MB Submitter Section PERSON MAKING THE SUBMISSION Submitter Name (required) Submitter Address: City: State: Zip: Submitter Email (required) Submitter Phone: Reference Section Provide References: Identify two individuals that can speak to the quality and significance of the achievement, and to the character of the candidate. REFERENCE #1 NAME TELEPHONE OR EMAIL Phone Email REFERENCE #2 NAME TELEPHONE OR EMAIL Phone Email