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Reporting Chapter/Shuttle:
Commanding Officer:
Name
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Home Phone
Email Address:
Nominee's Name: (not required for Chapter/Shuttle of the Year)
Nominee's Chapter:
Nominee's Rank: (not required for Chapter/Shuttle of the Year)
Nominee's SCC#: (not required for Chapter/Shuttle of the Year)
Award Requested: Member of the Year Award
Staff Member of the Year Award
Shuttle of the Year Award
Mothership of the Year Award
Chapter of the Year Award
Officer of the Year Award
CO of the Year Award
Enlisted Member of the Year Award
Junior Member of the Year Award
Scholastic Achievement Award
Helping Hands Award
Newsletter of the Year Award
Basis for Recommendation:

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