2020-2021 VANA Gala Industry Awards Night - Newsagent of the Year - Distribution - Industry Partner's Nomination

NOMINATION FORM - DISTRIBUTION

Question Title

* 1. Nominator Details

Name

Company

Email Address

Phone Number

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* 2.
Nominee Details

Contact Person

Newsagency/Company

Email Address

Phone Number

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* 3.
DECLARATION

I warrant that the information submitted in this entry is true and correct.

Date / Time

Date

Question Title

* 4. Signed By