Centennial Retailer Nomination Form

Nominee Criteria

Must have been in operation for at least 100 years
Must have a store location in Alabama

This field is for validation purposes and should be left unchanged.

Company(Required)

Owner/Contact Name(Required)

First Last

Title

Address

Street Address City State / Province / Region ZIP / Postal Code

Phone(Required)

Email(Required)

Year Business Opened

Name

First Last

Title

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Phone