Nominate the peacemaker

Nominate the peacemaker whom you admire for the 2017 Jerusalem Peace Prize
Name of Nominee *

First Name Last Name
Name of person submitting this nomination *

First Name Last Name
Date submitted *

- Month - Day Year
Date
Rationale for nomination *

(200 words) 0/200
Contact details of the nominee (if available):
E-mail (nominee) *
example@example.com
Phone Number

- Area Code Phone Number

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Contact details of person submitting this nomination:
E-mail (nominator) *
example@example.com
Phone Number

- Area Code Phone Number

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Supporting materials
Please attach material to support your nomination and indicate attachments here:

CV References Articles Links
Should be Empty:

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