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* 1. NEW Old Timer nominee's name:

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* 2. Nominee's address:

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* 3. Nominee's present or past place of employment:

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* 4. The year he or she started foundry work:

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* 5. Nominee's date of birth:

Date

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* 6. Please state the reason(s) why your nominee should be recognized as a NEW Old Timer.

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* 7. Are you aware of any changes or updates pertaining to a current Old Timer, such as a change of address?  If so, please share.  Thank you!

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* 8. Your contact information:

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