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Township of Terrace Bay Sports Wall of Fame: Builder Nomination Form
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Name of Nominee
Your answer
Current (or last known) Address of Builder Nominee
Please provide City/Town, Province/Postal Code
Your answer
Nominee Email
Your answer
Builder Nominee Phone Number
Your answer
Builder Nominee Alternate Phone Number
Your answer
Date of Birth
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DD
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YYYY
Place of Birth
Your answer
Years residing in Terrace Bay
Please provide the year range nominee lived in Terrace Bay i.e 1965-2016
Your answer
Is the builder nominee deceased?
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