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KYSE Nomination Form 2019
Kiss Your Self Esteem: A Weekend Retreat of Restoration for Women After a Life-Altering Event
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Nominee Name
*
(First, Middle Initial, Last)
Your answer
Your Name
*
(First, Middle Initial, Last)
Your answer
Why do you feel this person should participate in KYSE?
*
Please define the life circumstance and why they would like to participate
Your answer
Today's Date
*
MM
/
DD
/
YYYY
Your Contact Telephone
*
Your answer
Your E-mail Address
*
Your answer
The trip must be taken February 6th - February 15th (some time in this window) .
Will your nominee be available?
Your answer
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