2019 Altavista Chamber Awards Nomination
Please fill out this form to nominate for an award.
Nomination For:
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Cornerstone Award
Business of the Year
1. Nominee Information
Individual, Business or Non-profit Being Nominated
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Individual/Business/Non-Profit Name
Business or Non-Profit Representative Name
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First Name
Last Name
Nominee's Phone Number
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-
Area Code
Phone Number
Nominee's E-mail Address
Nominee's Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
2. Your Information
Your Name
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First Name
Last Name
Reason For Nomination
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Explain why your nominee deserves the selected award. Please submit up to five reasons for your nomination.
Your E-mail Address
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Your Phone Number
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Area Code
Phone Number
Your Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Send Nomination
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