暗黑爆料网 | Police Department | Challenge Coins

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    • What is a Challenge Coin?

    • SOCIAL MEDIA
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    Challenge Coins

    Nominating Individual

    *First Name:

    *Last Name:

    *Phone:

    *Email:

    *You are a:
     Student
     Faculty
     Staff
     Other

    Do you want to be notified/present if the person is going to receive a coin?
     Yes
     No

    Nominee Information

    *First Name:

    *Last Name:

    *Nominee is a:
     Student
     Faculty
     Staff
     Other

    *Phone Number:

    *Why should your nomination should receive a coin:

    Security Password (Please type the word ):
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