NOMINATION FORM
UNMLA MUZZLELOADER OF THE YEAR
INDIVIDUALS NOMINATED MUST BE CURRENT UNMLA MEMBER
INDIVIDUALS SUBMITTING NOMINATION MUST BE CURRENT
UNMLA MEMBER

NOMINEE: ____________________________________________________________
ADDRESS: _____________________________________________________________
CITY: ______________________________ STATE: _________ ZIP: ______________
CLUB AFFILIATION, IF ANY: ____________________________________________

    Please describe how the nominee has contributed to the betterment of muzzleloading in Nebraska.  Contributions may include (but not limited to) competitive shooting, rendezvous, historical interpretation, education, defense of the 2nd Amendment, or service to the UNMLA.  Nominations should not reflect activities primarily benefiting the nominee or his/her own club.  Be as specific and as brief as possible.
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
 Individual or Club submitting nomination: ______________________________________ 

Signature: ____________________________________________________________________

Mail to Sec./Treas. (Before July 15 of the current year)

Janice Libich
804 22nd St
Gothenburg, NE  69138

(Use extra paper if necessary)