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2. Name of Nominator*
4. Phone Number of Nominator*
5. Email Address of Nominator*
7. Name of Nominee*
9. Phone Number of Nominee*
10. Email Address of Nominee*
12. Criteria for Environmental Stewardship
    To recognize residents who have embraced the responsibility of protecting and improving the environment. Significant achievement in the field at the highest level available to them. Years of contribution will be a determining factor.
14. Please select all that apply *

    1. Made a significant impact to the Town of Slave Lake
    2. Enhanced to Quality of Life for the Town of Slave Lake
    3. Enhanced the image of the community
    4. Are a professional in their field

    1. Is an amateur in their field
    2. Being recognized for a single action
    3. Being recognized for an achievement over a period of time
16. Please provide further details on why your nominee should be awarded this recognition*
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18. 1. Receive an email copy of this form.
19. Email address

    This field is not part of the form submission.

20. Submit

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