Kenpo Hall of Fame Nomination Form
Mail to:
Kenpo Hall of Fame
Hall of Fame Registration
P .O. Box 24060
Lexington, KY 40524
I wish to nominate the following Kenpo Martial Artist to the 2011 Kenpo Hall of Fame.
Name: _______________________________________________
Address: City_________________________________
State _______ Zip________
Person making the nomination:
Name: ___________________________________ Rank __________ Age _______
Address: City_________________________________
State _______ Zip________
Phone ___________________
Signature ___________________________________________