Community Group Nomination Form

"*" indicates required fields

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First name*

Last name*

Email*

Your phone number

Type

Your position with Group

Group's contact phone number

State or Territory

Group Name (Will appear in Aura)*

Group Description. Approx. 100 words (Will appear in Aura)*

Group logo (Will display at 200x200 px)*

Accepted file types: jpg, png, jpeg, pdf, Max. file size: 2 MB.

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