Big Shots Nomination Form

The Arizona Partnership for Immunization (TAPI) is seeking nominations for the 2020 Big Shots of Arizona Awards.

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* 1. Provide your information (For the person submitting the nomination)

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* 2. Provide the full name of the person or organization that you are nominating:

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* 3. Are you nominating a person or an organization?

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* 4. Big Shot Award Categories (Choose the one category that BEST fits):

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* 5. Tell us about your nominee using data or specific examples to support your nomination (Files of support can also be attached below):

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* 6. Summarize in about three sentences the most outstanding outcome or impact of your nomination:

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* 7. Attach any supporting files here. 

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
Choose File

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* 8. Attach additional supporting file here.

DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only.
Choose File

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