YOUR NAME * First Name Last Name Email * Website http:// Phone (###) ### #### Facebook @ Instagram @ Twitter @ NOMINEE NAME/GROUP NAME * First Name Last Name Email * Website http:// Email * Phone (###) ### #### Instagram @ Facebook @ Twitter @ BRIEF DESCRIPTION ON WHY THIS INDIVIDUAL/ORGANIZATION HAS BEEN NOMINATED. WHAT DOES THE PERSON/ORGANIZATION DO THAT BENEFITS THE COMMUNITY? * Thank you!