Please only nominate one business and/or employee per form.

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* 1. I'm nominating a Cooper Small Business for an Award. Please provide the business name, address and contact information if known.

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* 2. I'm nominating this business because...

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* 4. I'm nominating the following person for a Cooper Business Person Award.

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* 5. I'm nominating them for the following Award

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* 6. Can we please get your contact information so we can pop you into our draw to win $100

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