APOLINARIO MABINI AWARDS NOMINATION
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I. CATEGORY FOR THE NOMINATION
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II. GENERAL INFORMATION ABOUT THE NOMINEE
A. FOR CATEGORIES A, B, C, D, E, G, H, & I
Name (Person/Group/Organization Being Nominated):
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Address:
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Age:
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Citizenship:
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Occupation:
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Education Background:
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Work Training
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Type of Organization (as appropriate)
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Nature of Disability (as appropriate)
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FOR CATEGORY C ONLY (EMPLOYER)
Name: (Employer/Company/Firm Being Nominated
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Address 1:
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Name of Business:
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Telephone number
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Date Established
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No. of PWD (Disabled) Employed:
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Type of Position Held by Disabled:
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Name of Nominating Person Organization:
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Address 2:
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Telephone Number
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Date Submitted
MM
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DD
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YYYY
Signature
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