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Advo - Excellence in consumer financial advocacy or protection award

Application Form

Nominee (Individual, organization or company)

Name (Company):
Address: (include city, state, zip, country)	,
Tel/Fax:
E-mail:

Owner, Director or other contact:
Above Person’s Tel/Fax:
Above Person’s E-mail:

Nominator (person nominating the Individual or Organization)
Note: Home address requested below will be used for internal purposes only.

Nominator Full Name:

Home Address:
(include city, state, zip, country)
,

Home Telephone:

E-mail:

Nominator Company:

Address:
(include city, state, zip, country)
,

Tel/Fax:

E-mail:

Relationship to Nominee
(Indicate "Self Nomination" if appropriate)

Length of Relationship

Mandatory Attachments

Maximum two-page summary of why the individual, organization or company should receive the award

Optional Attachments

Letters of recommendation from community leaders or constituents.

Please mail or e-mail your completed application by Friday, September 3, 2004. Faxes will not be accepted.

Consumers United Association
Right on the Money Award
Attn: Renée Beauregard
1009 Grant Street
Denver CO, 80203
Nominations may be sent by e-mail to: (No faxes, please)
cua@cuacolorado.org


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