Christmas Wishing Tree Nomination 
You can complete this form on behalf of your own household or to nominate a household who have been affected by the 2022 floods.
While we cannot guarantee that we can assist everyone who is nominated we will try our best to complete all requests. 

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Person completing this form (name and phone) *
Are you completing this form for your own household or nominating a household  *
How many people reside in the household  *
Contact name for household  *
Contact number for household *
Ages and genders of people in household  *
If known interests of those in household
Does the household need a Christmas tree?
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