Social Butterflies Foundation Holiday Outreach Program
Thank you for your interest in our nomination of families for the Social Butterflies Holiday Giving Program. You may submit a nomination by filling out the general form below, or by emailing us directly at info@socialbutterfliesfoundation.org. When you send your nomination, please provide us with the following information:

ABOUT YOU:

– Your name, phone number, and email address
– Your relationship to the nominated family

ABOUT THE FAMILY YOU ARE NOMINATING:

_ Nominee must have a child and be living with Lupus and/or Fibromyalgia or have a child that has Lupus and/or Fibromyalgia. You can self-nominate.
– Nominee must live in the Hampton Roads, Virginia area.
– Nominee first and last name, phone number, and email address
– Each family member’s name, relationship, and age
– Please take a moment and tell us why this family should be adopted by the Social Butterflies Foundation Holiday Giving Program.

**PLEASE NOTE THAT A MEDICAL RELEASE WILL NEED TO BE SIGNED FOR THE NOMINEES THAT ARE AWARDED.**.
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Email *
Nominations
Your Name *
Phone *
Relationship to Nominated Family *
Please tell us why this family should be adopted by Spirit of Giving. *
Nominated Family Information
Name *
Butterfly Affiliation *
Family Member's Names, Relationship, & Ages *
Family Address *
Please include full address (house number, street, city, state, zip code)
Family email/phone number *
A copy of your responses will be emailed to the address you provided.
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