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Good Egg Award Nomination

Your First Name

Your Last name

Your Email

Your Phone

Your Address

I am at least 18 years of age.

The nominee(s) resides in the Burgettstown/Tri-State Area.

The nominee(s) embody the ideals symbolizing the "Good Egg" attitude by selflessly giving to, or assisting others and therby improving the quality of life in the Burgettstown Area.

Nominee's First & Last Name, Address & Contact information

Reason for Nomination*

Thank you for nominating! Recipient will be announced on May 12th!

This form no longer accepts submissions.

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Burgettstown Community Library

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Tuesday: 9am - 6pm

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Saturday: 9am - 4pm

Email: librarian@burglibrary.org

Phone: 724-947-9780

Fax: 724-947-5116

Address: 2 Kerr Street

Burgettstown, PA 15021

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