If you or someone you know is eligible, please complete and return this form by September 15, 2018 to be recognized at the SDML Annual Conference in October and inthe November issue of South Dakota Municipal Magazine.

Please provide a photo and a one paragraph description (100 words max, please email if possible) of the Inductee’s biography or major accomplishments while serving the munici-pality to be used in the November magazine. Digital photos must be at least 300 dpi.

Return to: SDML, 208 Island Drive, Fort Pierre, SD 57532 Fax: 605-224-8655 Email: lisa@sdmunicipalleague.org

The South Dakota Municipal League Hall of Fame was created to honor those elected and appointed officials and employees who have served municipalities in South Dakota for 20 years or more.

Applicants,Applicants, living or deceased, must have completed 20 years of service as of September 30, 2018. Inducteeswill be recognized at the October 4th Annual Conference Luncheon.

YYears of service do not have to be consecutive or with the same munici-pality. Recognition will be one time per individual.

This recognition will be ongoing, if 20 years of service is completed after September 30, 2018 the official will be eligible to be inducted into the 2019 Hall of Fame.

Inductee Information(Type or print clearly)

____________________________________ _______ _________Name Living Deceased

_____________________________________________ _________Title Retired: Y/N

____________________________________________________________________________________________________________Municipality

______________________________________________________Mailing Address

________________ _____________________________________Total Years Served Offices/Positions Held

_____________________ ________________________________PhonePhone Email

Will Inductee be attending the recognition luncheon? Yes__ No__(If not registered for conference, meal tickets can be purchased on site.)

2018