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2. Nominator's Name*
4. Nominator's Email*
6. Name of Building/Site*
8. Description of Building/Site
10. Address of Building/Site*
12. Picture*

    Please upload your best photo of the building/site.

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14. 1. Receive an email copy of this form.
15. Email address

    This field is not part of the form submission.

16. Submit

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