Name of business you are nominating for Business of the Year:

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* 1. Name of business you are nominating for Business of the Year:

Address of business you are nominating for Business of the Year:

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* 2. Address of business you are nominating for Business of the Year:

This business deserves to be the Business of the Year because:

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* 3. This business deserves to be the Business of the Year because:

What is your full name?

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* 4. What is your full name?

What is your street address?

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* 5. What is your street address?

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