Pacific Northwest Koi Clubs Association

Ed Fujimoto Award Nomination Form

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To nominate a club member complete the form below:
you will receive a responding thank you email when you have correctly submitted your nomination--if you do not receive that email contact the

Ed Fujimoto Nomination Form

Click here after you have submitted the completed form and received your "thank you" response - to return to the website.

PNKCA Club Name
Nominee First Name
Nominee Last Name
Retype First Name
Retype Last Name
Nominee Address
Nominee City
Nominee State
Nominee Zip Code
Nominee Phone Number
Reasons why this person is being nominated
Your Name
Your Address
Your City
Your State
Your Zip Code
Your Phone Number
Your Email Address

If you have problems with the form, contact Phyllis at  or 208-762-5749