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Nominee Information
Details about the person being nominated.
Nominated Person
*
First
Last
Phone
Email
*
of of /
Reason for Nomination
*
Why do you believe this person deserves a life membership for Geelong Jaguars Hockey Club
Nominator
Details of the Geelong Jaguars Member submiting the nomination.
Nominator Name
*
First
Last
Phone of Nominator
Email of Nominator
*
Confirmation of Nomination
I confirm this nomination
Date / Time
Date
Time
Submit
