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Nominatation Form

NASFT Membership

12th Annual Retailer Awards Nomination Form

Nomination Deadline: February 16, 2012

Company Name: *

Contact Name: *

Email: *

Phone: *

Nomination 1

Retailer Name:

Street Address

City

State

Zip

Retail Category:

Other Category Name:

Nomination 2

Retailer Name:

Street Address

City

State

Zip

Retail Category:

Other Category Name:

Nomination 3

Retailer Name:

Street Address

City

State

Zip

Retail Category:

Other Category Name:

Nomination 4

Retailer Name:

Street Address

City

State

Zip

Retail Category:

Other Category Name:

Nomination 5

Retailer Name:

Street Address

City

State

Zip

Retail Category:

Other Category Name:

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