Please input the Extraordinary persons information

At this time we only deliver Extraordinary People Awards in the High Desert.

Extraordinary Persons First Name

Extraordinary Persons Last Name

Extraordinary Persons Address

Extraordinary Persons City

Is there a specific time or Date you would like for us to deliver the Award?

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Date

Time

Please share with us how this person demonstrated Selfless Love

Is it okay for us to share this story publically?

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Please input your information

First Name

Email *

Phone *

Organization

Last Name

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