Jeannette Hughes Accessibility Award

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* 1. Name of individual, organization or business you are nominating:

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* 2. Address:

Street:

City:

Province:

Postal Code:

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* 3. Phone:

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* 4. Email

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* 5. Please describe how the nominee has contributed to inclusiveness and accessibility in Sidney.

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* 6. Your name

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* 7. Your Phone Number:

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* 8. Please provide two references who can be contacted for details about the individual, organization or business:

Name:

Phone:

Name:

Phone: