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WLLA AWARDS NOMINATION FORM
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| Name________________________________________________________________________
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| Address______________________________________________________________________
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| Region Represented (if
appropriate)_______________________________________________
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| Rationale for Nomination: (must be completed, feel free to attach supporting meterials) |
| ___________________________________________________ Name of Person Submitting Nomination |
_____________________________________ Region |
Mail or Fax all materials to:
Diane McQueen Beverly Bell
3200 West C Street 231 W. Sixth St.
Torrington, WY 82240 Powell, WY 82435
307-582-8383 (f) 307-754-6166 (f)