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* 1. Name of Nominee : Company or Individual

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* 2. If company, please list name of an individual.

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* 3. Category of Progress

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* 4. Sector?

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* 5. Email of Nominee

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* 6. Phone Number of Nominee

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* 7. Email of Nominator 

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* 8. Phone Number of Nominator

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* 9. Please include any additional notes here.

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