ONE Award Nomination Form
Name of Nominee
*
First Name
Last Name
Organization
*
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Country
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Nominated by: (Your Name)
*
Please provide an explanation of why the nominee should be considered for the award:
*
Submit
Should be Empty: