Rosemary Brown Racial Justice Nomination Form
Nominee Information
Please provide a detailed description of candidate’s background, relevant experience and reasons why an individual or organization should receive the award. The description should be approximately 500 words.
Nominated Person or Organization
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Describe
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0/500
Categories - Please check one category:
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Individual
Group
Women
Youth (under 25)
Please check which sub-category would best apply to the nominated candidate:
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Community Work
Health
Business
Sports
Journalism
Politics
Education
Arts
Other
E-mail
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example@example.com
Phone Number
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Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Nominator:
Person submitting the nomination
Full Name
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First Name
Last Name
E-mail
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Submit
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