The National Historic Chemical Landmarks Program

Fill in all categories and submit to the American Chemical Society's Office of Communications. You can also download a PDF version of this form.

Sponsor:

Local Section, Division, or Committee:

Date of Submission to ACS Headquarters:
Primary Preparer:	(to whom correspondence should be addressed)
Address:
Telephone:
Fax:
E-Mail:

NOTE: ALL INFORMATION MUST BE COMPLETE FOR CONSIDERATION BY THE NHCLP ADVISORY COMMITTEE.

a. Seminal achievement:

b. Significant historical date(s):

c. Historical significance of this work:

d. Location:

e. What sets this work apart from related achievements:

f. Supporting evidence :
(List links or describe documents, photos, etc. to be mailed under separate cover)

g. Present condition and availability to the public:

h. List of commitments for financial support: