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Online Nomination Application

Online Nomination Application

Additional information may be attached to this application such as references, newsletter clippings, reviews, resumes, etc. that will help the nominee get selected for the award.

For further information, please call (856) 225-5312 or e-mail to hispanic@camdencounty.com

DEADLINE FOR SUBMISSION: Friday, September 6, 2011

Nominee::

Organization:

Address:

City:

State:

Zip Code:

Telephone (Work):

Telephone (Home):

Telephone (Mobile):

Email Address:

Your Name (Optional):

Your Organization:

Your Address:

Your City:

Your State:

Your Zip Code:

Your Telephone (Work):

Your Telephone (Home):

Your Telephone (Mobile):

Your Email Address:

Would you like to receive periodic updates of events, happenings, , alerts, etc. in Camden County:

Yes

Why do you feel this person should receive this award? Briefly give reason or list his/her accomplishments in the community:

How long has he/she been serving the community?:

What is the single most important reason this person should be recognized for an award:

Online Nomination Application

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