COMMUNITY LEGACY AWARD 2008
APPLICATION FORM

Name of Community ___________________________________________________________

Person Completing This Application ________________________________________________

Title and Organization ___________________________________________________________

Address _____________________________________________________________________

            ____________________________________________________ ZIP ______________

Telephone __________________________________ Fax _____________________________

Email _____________________________________ Web ____________________________

On no more than four attached pages, please indicate what your community has done or is planning in each of the criteria mentioned. Photographs may be included.

Return this application by March 3, 2008 to:

        Leslie Townsend, Interim Director
        Historic Southern Indiana
        University of Southern Indiana
        8600 University Blvd
        Evansville IN 47712

For further information, call (812) 465-7014 or email ltownsen@usi.edu