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Please use this form to nominate a member for a position on the board of directors.
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| Community Name:: | * |
| Name of Nominee: | * |
| Address of Nominee: | * |
| Please state the reasons that this nominee would make a good director. This information will be shared with the community: | * |
| Your name (optional): | |
| Your e-mail address (optional): | |
| To prevent automated SPAM, please enter HQPB to submit your form (case sensitive): | * |
* indicates required field
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