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FOR COMMUNITY SERVICE AWARD
*
required information
* Name of Program:
* Sponsoring Organization:
Agency Director:
Address:
Postal Code:
Phone (Day):
Phone (Evening):
* Please state your reason(s) for nominating this Program.
List special aspects of this Program which make it worthy of this Award:
* What impact has this Program had on community life:
The Deadline for ALL submissions is:
July 11th, 2008
Nomination Submitted by:
* Name:
Address:
* E-mail:
Phone (Home):
* Phone (Work):
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© 2008
FEDERATION CJA
For more information: 514.345.2645 ext. 3382
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