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* 1. Today's Date

Date / Time

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* 2. What is your name? (First and Last Name)

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* 3. Who are you nominating? (First and Last Name)

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* 4. What partner agency does he/she volunteer with? 

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* 5. What is the Agency Account Number?

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* 6. Why are you nominating this person for SMFBA's Volunteer of the Month?

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* 7. What 3 words would you use to describe the nominee? 

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* 8. What is your email and phone number so we can contact you with any follow up questions?

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