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* 1. Your name:

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* 2. Your phone number:

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* 3. Your email:

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* 4. Name of the person you are nominating:

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* 5. Nominee's email:

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* 6. Nominee's phone:

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* 7. Please tick boxes that best describe the persons involvement in general aviation.

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* 8. How many years has the nominee been involved in general aviation?

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