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Nominee's Information:
Full Name:
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Job Title:
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Company:
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Phone Number:
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E-mail:
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Relevant Experience:
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Awards/Community Involvement:
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Average Employer Client Size:
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100 lives and under
101 to 1,000 lives
1,001 to 5,000 lives
5,000 or more lives
How does the nominee's level of service differentiate from their peers?
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What aspect of the nominee's career makes them a candidate for Broker of the Year?
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Your Information:
Are you nominating a colleague? Please fill in your information below. This information will only be used to contact you with questions about your nomination.
Full Name:
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Phone Number:
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E-mail:
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