Washington Trust for Historic Preservation

Endangered Place Basic Information
Name of Place:*
Historic, Popular, or Other Name(s):
Date Constructed:
Architect(s), Engineer(s), and/or Designer(s):
Physical Address of Place:
Street Address City State ZIP Code
Geographic Coordinates:
If the place does not have a clear street address, please include its latitude and longitude:
Is this property listed in the National Register of Historic Places?
Please upload a copy of the nomination form for the National Register:
Please upload a copy of the nomination form for the National Register:
Max. file size: 50 MB.
Is this place designated in a local register?
- Yes
- No
Please identify the local listing/register:
(i.e. City of Seattle Landmark, Spokane Register of Historic Places, etc.)
Please upload a copy of the nomination/designation document for this place to the local register:
Please upload a copy of the nomination/designation document for this place to the local register:
Max. file size: 50 MB.

Save and Continue Later

Nominator Contact Information
Would the nominator prefer their name be kept confidential?
- Yes
- Not necessary
Is the nominator also the property owner?*
- Yes
- No
This nomination is being submitted by:*
- An individual
- An organization
Name:*
First Last
Nominating Organization:*
Contact Name:*
First Last
Title/Position:
Organization Website:
Email:*
Phone:*
This phone number is:
- Cell
- Home
- Work
Mailing Address:*
Street Address City State ZIP Code

Save and Continue Later

Property Owner Information
Property Owner's Name:*
First Last
Property Owner's Email:
Property Owner's Phone:*
Property Owner's Address:*
Street Address City State ZIP Code
Does the owner support this nomination?
- Yes
- No
- Not sure
Have the nominator or other individuals been in contact with the owner about their concerns for this place? If so, please describe.

Save and Continue Later

Media Information
Please provide contact information for at least one contact at a local or regional media source (newspaper, television, online, etc.). The more contacts you can provide, the more helpful it will be in spreading the Most Endangered Places announcement.
Media Contact Name*
First Last
Name of publication/media source*
Email*
Phone
- Add another media contact
Media Contact #2 Name
First Last
Name of publication/media source
Media Contact #2 Email
Media Contact #2 Phone
- Add another media contact
Media Contact #3 Name
First Last
Name of publication/media source
Media Contact #3 Email
Media Contact #3 Phone
- Add another media contact
Media Contact #4 Name
First Last
Name of publication/media source
Media Contact #4 Email
Media Contact #4 Phone
- Add another media contact
Media Contact #5 Name
First Last
Name of publication/media source
Media Contact #5 Email
Media Contact #5 Phone
Existing Media Coverage
Please provide links to any media coverage or press releases regarding the issue:

Save and Continue Later

Most Endangered Places Nomination Form