2019 Gala Awardee Nomination Form
Please complete the form below to submit your nominee's name for the 2019 Candace Award
Nominator's Contact Information - please provide your name and email address.
Nominee's Contact Information - please provide the name, email address, phone number, title and organization/employer of the nominee.
Is the nominee aware that you are nominating her?
Please indicate the award category for which you are nominating this person. (Select one)
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