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* 1. Name of Nominee:

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* 2. Nominee Phone Number:

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* 3. Nominee Email Address:

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* 4. Nonprofit organizations, civic groups and/or partners involved:

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* 5. Brief paragraph (3-5 sentences) as to what the recent solution or impact has been in the community as a result of their collaborative efforts to go after something bigger - and better - together!

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* 6. Nominator First and Last Name: 

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* 7. Nominator Phone Number:

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* 8. Nominator Email Address:

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