Nomination Form for the
Territorial Women's Memorial Rose Garden

To nominate a woman to the Territorial Women's Memorial Rose Garden, please provide the following biographical information for review by the Sharlot Hall Museum Rose Garden Committee. All nominees must have been in Arizona before statehood on February 14, 1912.

Nominee's full name (including middle, maiden, and all married names):

Names of nominee's parents:

Nominee's Birth Date and Place:

Nominee's Death Date and Place:

Location of burial:

Date and first place of settlement on arrival in Arizona:

Marriage(s) date and place (Include information for additional marriages on a separate sheet if needed):

Full name of husband(s):

Addresses of nominee while living in Arizona (street addresses if possible):

Occupations and/or avocations:

Organizations and church affiliations:

Education: (Give names and locations of schools, degrees or certificates, and dates)

Children: (Give names and dates of birth, and married names of daughters)

Other things we should know about the nominee:

Nominated by:
Name:

Organization:

Address:

Phone number:

E-mail address:

Submit photographs, if available, and include any additional historic information, including writings, honors, reminiscences, etc. Additional materials may be submitted at any time.

I convey to the Sharlot Hall Historical Society the right to reproduce as it sees fit the information and any included materials associated with this Rose Garden nomination. It is understood that materials shall be displayed at the discretion of the Museum staff and will not necessarily be on public view at all times and that the name of the nominator may not be with the information when it is exhibited.

Signature:

Date:

Donations are requested with nominations to help maintain the Territorial Women's Memorial Rose Garden, related archival collections, exhibits, and to sponsor programs related to these women.

Send this application, your donation, and any other materials to:
Rose Garden Committee
Sharlot Hall Museum
415 W. Gurley Street
Prescott AZ 86301

Additional information about the Rose Garden and nomination forms are available at sharlot.org/archives/rosegarden or call 928.445.3122.