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Nomination #1: Nominee Contact Information
The following fields pertain to you as the retailer.
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Retailer Name:(*)
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Email:(*)
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Store Category:
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Phone:(*)
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Website:(*)
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Address Line 1:(*)
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Address Line 2:(*)
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City:(*)
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State:(*)
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Zip:(*)
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Please describe why you should be Retailer of the Year.(*)
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Name of the Representative who will "second" you:
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