ICFA Apollo Award Nomination Form - 2018
Multi-Store
ICFA Member Name:
Company:
Phone:
Contact Name:
Contact Email:
Top Choice (Score: 5 points)
Store Name:
Address:
Contact Name:
Contact Phone #:
Second Choice (Score: 4 points)
Store Name:
Address:
Contact Name:
Contact Phone #:
Third Choice (Score: 3 points)
Store Name:
Address:
Contact Name:
Contact Phone #:
Fourth Choice (Score: 2 points)
Store Name:
Address:
Contact Name:
Contact Phone #:
Fifth Choice (Score: 1 point)
Store Name:
Address:
Contact Name:
Contact Phone #:
Please submit this form by Friday, June 22.

If you have questions, please contact Jackie Hirschhaut at 336-881-1016 or jackie@icfanet.org.

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