Holiday Streakers Recipient Nomination Form
Please provide the following information to be considered by our Nomination Committee as a potential recipient for Holiday Streaking 2018. See our website (www.holidaystreakers.com) for more information about what Holiday Streaking is. Happy Streaking!
Recipient/Family Name
Your answer
Location (City and State)
Your answer
Please provide some information about the nominee or the nominee family (possible info could include family members, vocations, how you know them, hobbies they have, activities they enjoy, or anything else that would help the committee feel like they "know" the recipient/family).
Your answer
Please provide specifics regarding the health issue this nominee/nominee family is facing and how this has burdened them financially (how the donation may be used to ease financial burden). Be as descriptive and thorough as possible.
Your answer
What makes this nominee/family special to you? Why do you feel they would be a deserving recipient?
Your answer
Does the nominee/family know you are nominating them as a potential recipient for Holiday Streakers?
If chosen, is the nominee/family willing to have information regarding their challenges posted by Holiday Streakers on our Facebook and holidaystreakers.com website?
Additional Comments
Your answer
Your name
Your answer
Your email
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms