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CMC Department of Aging & Disability Services 2013 Outstanding Service Recognition Award Official Entry Form Name of Individual/Business/Organization:____________________________ Nominee’s Address: Nominee’s Phone Name of person completing Address: Phone Relationship to Nominee (employee, customer, family, friend, etc.) Please complete a brief synopsis of why you feel the individual or organization should be recognized. Include specific examples of their efforts on behalf of individuals with disabilities. (Please no more than 750 words; attach additional paper if necessary.) Mail to: Cape May County Department of Aging & Disability Services 4 Moore Rd, DN620, Cape May Court House, NJ 08210-1654 Email to: [EMAIL REDACTED] DEADLINE FOR APPLICATION SUBMISSION: OCTOBER 26, 2013