Nominee Details

Full Name *

Email *

Phone

What does the business do? (2-3 sentences) *

How long has the business been running? *

Website or social media link? (optional)

Why do you need this van? *

Attendance: *

I agree I know about the nomination and can attend December 2

Driver's License *

I or the nominee as a valid driver's license

Area of Saskatchewan *

The business owner lives or operates their business in Regina

Keep me posted on Straightline AI news (optional)

Yes, please keep me up to date on Straightline AI news

By checking this box, I consent to receive non-marketing text messages from [BUSINESS NAME] about [USE_CASE_FROM_CAMPAIGN_DESCRIPTION]. Message frequency varies, message & data rates may apply. Text HELP for assistance, reply STOP to opt out.

By checking this box, I consent to receive marketing and promotional messages including special offers, discounts, new product updates among others, from [BUSINESS NAME] at the phone number provided. Frequency may vary. Message & data rates may apply. Text HELP for assistance, reply STOP to opt out.