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GE Appliances Community Heroes

GE Appliances Community Heroes Nomination Form

Please complete all details below.

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Submitter Information

First and Last Name

Value is required

Email Address

Value is required

Phone Number

Value is required

Home City and State

Value is required

Nominee Information

Name of Organization

Value is required

Name of Contact Person at the Organization

Value is required

Phone Number of Organization

Value is required

Email Address of Organization and/or Contact Person

Value is required

Address for Appliance Delivery

Value is required

City and State

Value is required

Suggested Appliance Donation

Value is required

Please describe in three hundred words or less the mission of this organization and how this appliance donation will advance the services they provide to the community

Value is required

Submit

Thank you!