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* 1. I am proud to nominate

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* 2. Nominee's age

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* 3. Nominee's address (Street, City, State, Zip Code)

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* 4. Nominee's phone number

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* 5. Nominee's email address

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* 6. My name is

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* 7. My address (Street, City, State, Zip code)

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* 8. My phone number

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* 9. My email address

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* 10. Please briefly tell us about the nominee (where they are employed, how they’ve overcome adversity, how they exemplify selflessness, kindness, promote strong family unity and is active in her community). The theme for this year's Single Mothers' Conference is Resilience and Reinvention. How does this single mom exemplify this theme?

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