Current Owner Information

Owner's name
Owner's address
Owner's phone number
Owner's email address

Nominated By Information

Your name
Your address
Your phone number
Your email address
Does the Owner Agree to be Nominated?(Required)
Type of Property?(Required)

Property Information

(please provide all that you can)

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