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Name of Nominee
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Position & Title
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Work or Home Address (If retired, contact information should reflect home address).
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City, State, & Zip Code
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Phone Number
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Email Address
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Nominator's Name
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Nominator's Position & Title
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Nominator's Phone Number
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Nominator's Email Address
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Reason for Nomination - the following should be included in the narrative: local contributions, state/regional, and national contributions, including honors or recognitions, professional offices, and committee appointments; and publications and/or significant contributions to the field of Family and Consumer Sciences Education.
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