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* 1. Do you have the best story from the Wellness Challenge? Submit your fun or inspirational story for the chance to win a special prize!

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* 2. Does Small Business Majority have your permission to share your story during one of our celebration events at the end of the Wellness Challenge?

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* 3. Does Small Business Majority have your permission to promote your story via social media or a blog post?

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* 4. Was there someone at your company who stood out during the Wellness Challenge as a leader or source of inspiration? Nominate them here! The most popular nominee in each city could win a prize!

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* 5. What is your business / organization's name?

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* 6. What is your name?

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* 7. If you consent to being contacted by Small Business Majority staff to follow up on your story, please leave your phone number and/or email in the box below.

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