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HEART 4 Her Adopt-a-Teen Mom Christmas Campaign Nomination Form
H.E.A.R.T 4 Her | Healing, Empowering and Restoring Teen moms. 

Founded by a former teen mom who knows firsthand the challenges, sacrifices, and perseverance required to overcome adversity, H.E.A.R.T. 4 Her was created with a deep passion to help young mothers thrive. 

Our founder’s journey began at just 15 years old when she became a mother, balancing parenthood with her education and future aspirations. With unwavering determination, she pursued higher education, eventually earning her degree and rising to become a CFO of a global tech company. Now, she is committed to giving back to teen mothers by offering them the support, encouragement, and opportunities that were once provided to her. 

As we celebrate the third year of our annual Adopt-A-Teen Mom Christmas Campaign, we continue to spread hope, joy, and love during the holiday season to teen moms in our communities. Over the past two years, we’ve made meaningful impact in the lives of young mothers, and with your help, we hope to make this year our most successful yet. By nominating a deserving teen mom, you are helping us fulfill our mission of empowering and uplifting those who need it most.

Thank you for taking the time to nominate a teen mom for our annual campaign. 

Please fill out the form below with as much detail as possible to help us select deserving recipients.

All information will remain confidential and will only be used for the purposes of this campaign.


Thank you for your nomination and supporting H.E.A.R.T 4 her’s mission to uplift teen moms. 
Kennedy, Hailey, Emily & Heather


Email *
Nominator - First & Last Name
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Nominator - Email
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Nominee - Full Name & Age
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How many children does the nominee have?
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Nominee - City, State
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Nominee’s story
Please tell us about the nominee. We would like to know about her current situation, the challenges she faces as a teen mom, and how she could benefit from this program.
(500 words max)

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Will you be able to provide the nominee’s full address & a list of needs within 5 days of selection?
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Children’s gender & ages
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Is the nominee currently pursuing education or training? If yes, please specify:
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Is the nominee currently employed?
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Impact of the Campaign
How do you believe the Adopt-A-Teen Mom Christmas Campaign will positively impact the nominee and her children?
(300 words max)

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Additional Information
Is there any other information you would like us to consider when reviewing your nomination?
(Optional)

Nominator - Full Name
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Relationship to Nominee
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Nominator - Contact Information
(Phone/Email)
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A copy of your responses will be emailed to the address you provided.
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