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1. Your Name (Required.)

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2. Nominee's Full Name (Required.)

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3. Why does this person deserve a Cozy Care Package? (Required.)

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4. Nominee's Shipping Address (Required.)

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5. Nominee's City (Required.)

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6. Nominee's State (Required.)

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7. Nominee's Zip Code (Required.)

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8. Nominee's Shoe Size (indicate Men's or Women's) (Required.)

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9. Nominee's Social Handles (Required.)

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