Nomination   
 
Submission - October 2019
 
Make a submission by filling out the form below. You may also include a picture of the person, persons or local community organization you are nominating. Please keep your nominations brief and to the point, yet substantial enough to include relevant details.
 
General Information
 
* First Name: 
 
* Last Name: 
 
* Email: 
 
* Confirm Email: 
 
Phone: 
 
Submission Information
 
* Submit Your Text: 
 
Double check to make sure your entry is correct and then hit submit below.
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