Farm Equipment/Rural Lifestyle Dealer 2011 Dealership of the Year Nomination Form

1.

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1. Dealership Name: (Required.)

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2. Please provide the following information for nominated dealership. (Required.)

Contact Name: *

Address:

City/Town: *

State: *

Email Address:

Phone Number:

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3. Why should this dealer be chosen for Farm Equipment's or Rural Lifestyle Dealer's Dealership of the Year Award? (Required.)

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4. Please provide us with your contact information if different from above.

Name:

Company:

Email Address:

Phone Number: