Benjamin F. Dillingham, III & Bridget Wilson LGBT Veterans Wall of Honor Nomination Form

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Thank you for nominating an LGBTQ veteran to be inducted onto our Wall of Honor. Please submit this form and all supplemental materials by Thursday, June 30th for induction consideration this year.

Email *

This section is for information about the person being nominated.

Nominee's Full Name *

Branch of Service *

U.S. Army

U.S. Marine Corps

U.S. Navy

U.S. Air Force

U.S. Coast Guard

U.S. Space Force

Years in service *

For example: 1975-1979

Type of discharge *

Time lived in or served in San Diego *

Best description of ethnic identity *

Best description of gender identity *

Member of the transgender or nonbinary community? *

Yes

Best description of sexual orientation *

Pronouns *

For example: she/her/hers, they/them/theirs

Is candidate living or deceased? *

Living

Deceased

Candidate phone number *

If they are deceased mark n/a.

Candidate e-mail address *

If they are deceased mark n/a.

This next section is asking information about the person submitting this nomination form.

Name of nominating individual *

Relationship to nominee

Partner/Spouse

Friend

Sibling

Co-Worker

Other:

Clear selection

Your phone number *

Please describe how the nominee meets the nomination requirements (which are listed here: https://thecentersd.org/candidate-criteria/). Please write this section as if the Advisory Council knows nothing about the candidate, with a focus on the candidate's contributions in the following areas: military service, local LGBTQ community, LGBTQ community beyond San Diego, and local civic engagement. If desired, you may type the response to this section in a separate word processor like Word and paste it here.

Please list one additional San Diego County resident who will serve as a co-sponsor of this application including: full name, phone number, and email. *

Nomination check-list

Items that are separate from this online application (ie. nomination statement, DD214, etc) should be sent in separately by June 30, 2022 via e-mail to jhawthorne@thecentersd.org or post mail to:
The Center
c/o Rebekah Hook-Held
PO Box 3357
San Diego, CA 92163

Please check-off items you have completed/submitted. *

This completed nomination form

Nomination statement (as part of this nomination form)

E-signature of 1 co-sponsor. Find the form here: https://forms.gle/NFsAZrKJHhRAuau87

Form DD214 (or equivalent). Please not that only the veteran or the veteran's first of kin can get copies of a service member's DD-214 AND that it could take up to a month to receive one. They can be obtained at: http://www.archives.gov/veterans/military-service-records/

Other:

Required

If you are not submitting any piece of the required documentation from the nomination check-list, please note the reason below.

A copy of your responses will be emailed to the address you provided.

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