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2. Your Contact Information
   Please provide the contact information of the person making the nomination.
4. Name
5. Phone Number
7. Email Address
8. Confirm Email Address
12. Property Information
    Please provide the following information regarding the nominated property.
14. Property Address
16. Name of Property Owner
18. Property Category
    -- Select One --Single-Family HomeMulti-Family HomeSubdivision Entrance / Cul-de-sac IslandBusinessDoors of Palatine
20. Photo of Property
    Please upload one photo of the nominated property.
24. Join our mailing list?

    1. Yes

    1. No
Leave This Blank:


26. 1. Receive an email copy of this form.
27. Email address

    This field is not part of the form submission.

28. Submit

* indicates a required field