Pinehurst Historic Plaque Nomination Form

Address of Nominated Property(Required)

Historic Name of Nominated Property(Required)

Current Owner Information

Name(Required)

Owner's name

Address(Required)

Owner's address

Phone(Required)

Owner's phone number

Email(Required)

Owner's email address

Nominated By Information

Name(Required)

Your name

Address(Required)

Your address

Phone(Required)

Your phone number

Email(Required)

Your email address

Does the Owner Agree to be Nominated?(Required)

Yes

Type of Property?(Required)

Private Home

Public Property

Commercial Property

Other

Property Information

(please provide all that you can)

Year Built

Name of Original Owner

Timeline and Names of Previous Owners:

Timeline of Significant, Architectural Changes to the Exterior and Interior:

Historical, Cultural, or Social Significance to Pinehurst:

Other Pertinent or Interesting Information About the Property, its Owners, or Occupants:

File/Document Upload

(if you have more than 10 images/documents to submit or you would prefer to submit them via hard copy you may do so by mailing them to: Historic Plaque Committee PO Box 398 Pinehurst, NC 28370)

Upload Files

You can upload more than one file here by selecting multiple files in your computer's file explorer. A total of 128 MB is allowed.

Drop files here or

Accepted file types: jpg, gif, png, pdf, Max. file size: 1 GB, Max. files: 10.

Phone

This field is for validation purposes and should be left unchanged.