Lutheran Historical Society of the Mid-Atlantic Site Recognition Nomination Form

Is he or she a member of the Lutheran Historical Society of the Middle Atlantic?
YesNo

Is the owner/principal aware this site is being nominated?
YesNo

Is the owner/principal agreeable to the requirements for recognition, including the placement of the plaque, its formal presentation, and the grant for preservation of materials and publication of historical information about the site?
YesNo

To contact the Site Committee with questions or additional information email Phil Teigen: phil41@icloud.com.