Nominations for the Arkansas Insurance Hall of Fame Class of 2017.


Nominations will be accepted

January 1 through June 30, 2017

All Individuals Previously Nominated Will Remain in the Pool and Will Continue to be Considered for Future Classes of the Arkansas Insurance Hall of Fame.


Nominee Contact Information
Name of Nominee *
Name of Nominee
Phone Number of Nominee
Phone Number of Nominee
Home Address of Nominee
Home Address of Nominee
Business Phone Number of Nominee
Business Phone Number of Nominee
Business Address of Nominee
Business Address of Nominee
If deceased, closest relative contact information
Name of Relative
Name of Relative
Phone Number of Relative
Phone Number of Relative
Degrees, certificates, and designations (by year)
Professional Affiliations
Personal Contributions
Contributions of nominee in the personal area. Anything that relates to the nominee’s influence and leadership in his/her family, activities which promote the family as an essential social unit, leadership of and participation in church activities, etc. Recognition of good works may be included.
Professional Achievements
Achievements of the nominee in the insurance area (sales achievements, leadership positions held with carriers or agencies, leadership at the state, local, and national level in professional insurance or regulatory associations, awards and citations won by nominee for industry achievements, creation of an insurance company or agency or guidance of a major branch development, advocacy of consumer or insurance industry interests, and other achievements which reflect unusual organizational or occupational skills and end results orientation).
Community Service
Contributions of the nominee through civic, cultural, and community activities (involvement in and leadership of civic clubs, fraternal societies, service organizations, service on boards of directors of various organizations, etc.).
Submitted by
Name of Nominator *
Name of Nominator
Phone Number of Nominator *
Phone Number of Nominator
Date *
Date