Heritage Fellowship Nominations
Nominee Details
Applicant Type
*
Individual
Organization
Organization Name
*
Artist Name
*
First
Last
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Ohio County
*
Adams
Allen
Ashland
Ashtabula
Athens
Auglaize
Belmont
Brown
Butler
Carroll
Champaign
Clark
Clermont
Clinton
Columbiana
Coshocton
Crawford
Cuyahoga
Darke
Defiance
Delaware
Erie
Fairfield
Fayette
Franklin
Fulton
Gallia
Geauga
Greene
Guernsey
Hamilton
Hancock
Hardin
Harrison
Henry
Highland
Hocking
Holmes
Huron
Jackson
Jefferson
Knox
Lake
Lawrence
Licking
Logan
Lorain
Lucas
Madison
Mahoning
Marion
Medina
Meigs
Mercer
Miami
Monroe
Montgomery
Morgan
Morrow
Muskingum
Noble
Ottawa
Paulding
Perry
Pickaway
Pike
Portage
Preble
Putnam
Richland
Ross
Sandusky
Scioto
Seneca
Shelby
Stark
Summit
Trumbull
Tuscarawas
Union
Van Wert
Vinton
Warren
Washington
Wayne
Williams
Wood
Wyandot
Phone
*
Email
*
Birthdate
MM slash DD slash YYYY
Website
Ethnic Group
African American or Black
American Indian
Asian
Hispanic or Latino
Caucasian or White
Primary Art Form
*
Nominator Detail
Nominator Name
First
Last
Nominator Phone
Nominator Email
Relationship to Nominee
Narrative
Describe the traditional art form that the nominee practices or supports.
*
How did the nominee learn this art from and how long has the nominee practiced this art form? For Community Leadership describe how long the nominee has been engaged in supporting the folk and traditional arts.
*
What makes the nominee outstanding, compared to others working in the same art form?
*
Describe how their work has contributed to their community.
*
Describe how the nominee’s work deepens public understanding and appreciation of the folk and traditional arts.
*
Work Samples
*
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