Kenpo Hall of Fame Nomination Form
Mail to:
Kenpo Hall of Fame
Hall of Fame Registration
P .O. Box 558255
Chicago, IL 60655-8255
I wish to nominate the following Kenpo Martial Artist to the 2009 Kenpo Hall of Fame.
Name: _______________________________________________
Address: City_________________________________
State _______ Zip________
Person making the nomination:
Name: ___________________________________ Rank __________ Age _______
Address: City_________________________________
State _______ Zip________
Phone ___________________
Signature ___________________________________________