2018 VANA Industry Awards Night - Newsagent of the Year - Distribution - Newsagents Self - Nomination

NOMINATION FORM - DISTRIBUTION

Question Title

* 1.
Nominee / Nominator Details

Contact Person

Newsagency/Company

Email Address

Phone Number

Question Title

* 2.
DECLARATION

I warrant that the information submitted in this entry is true and correct.

Date / Time

Date

Question Title

* 3. Signed By