Hall of Fame Nomination Form
The Opelousas General Health System Foundation Hall of Fame provides a forum for the hospital to recognize, celebrate and publicize the work of exemplary individuals whose longstanding contributions have lasting impact on the hospital, the community and the patients we serve.  The awards will be presented at the Annual Hall of Fame Gala.
 

Deadline for Nominations is August 19, 2022. The Hall of Fame Gala is Thursday, January 26, 2023.

 

Return all Nominations to this address or complete this form:

OGHS Foundation
c/o Tracey Antee
703 E. Prudhomme St.
Opelousas, LA 70570
 
Nomination Form:

-          Nominee can be living or deceased.
-          Must have an affiliation with the hospital (physician, board member, volunteers or philanthropist).
-          Must have exhibited commitment to the hospital and the community.
-          Must have exhibited dedication to the healthcare field and the service of others.
-          Must not be a current employee or board member of OGHS.
 
Nomination Process:

-          Nominator should fill out this nomination form and provide a clear statement (two-page maximum) of the candidate’s contribution(s) as it relates to nomination criteria.
-          Inductee(s) will be notified 1 month prior to Hall of Fame Induction Ceremony.
-          Please send all nominations to OGHS Foundation, 703 E. Prudhomme St., Opelousas, LA 70570 or fill out this form.
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Who would you like to nominate? *
Your name? *
Phone Number *
Today's Date? *
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Address?
Email address? *
Please provide a clear statement (two-page maximum) of the candidate's contribution(s) as it relates to nomination criteria. *
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