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* 1. Please select the award that this nomination is for:

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* 2. NOMINEE INFORMATION:

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* 3. Please explain why this individual should be nominated for the award. Your comments may be used in the Awards Program or in the Palmetto Pharmacist.

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* 4. Please list any SCPhA activities, community activities, or other professional organization activities, including any offices held.

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* 5. Describe the nominee's professional experience.

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* 6. NOMINATOR INFORMATION:

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