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* 2. Nominee Name
(If nominating a program, please provide Program Name and Program Point of Contact Name)

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* 3. Nominee Title

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* 4. Nominee Agency/Company

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* 5. Nominee Email Address

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* 6. Nominee Phone Number

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* 7. Please briefly summarize why you are nominating this individual or program. 100 words or fewer, please.

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* 8. A little bit about you, the nominator:

IMPORTANT: Your nomination is not complete! Please submit a 300x300 high-resolution photo of your individual nominee or program to events@statescoop.com to complete your nomination. Your nomination will not be considered without a photo. Thank you!

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