Nominate a Beneficiary
Do you know of a beneficiary from the local hockey community that is in need due to a severe illness or injury?  Please fill out the information below to the best of your ability.  Also, feel free to contact us at info@nocopondhockey.org to explain further or follow up as needed.  Thank you!
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Email *
Your Name *
First and last name
Your Email Address *
Your Phone number *
Name of Beneficiary that you are nominating *
First and last name
When was this person's date of injury? *
Please give us as much information as you can about the nature of the injury/illness that your nominee has suffered from and the financial impacts that they are currently facing. *
Tell us a little bit about the urgency of the need for assistance for this nominee *
What type of assistance are you seeking for this nominee at this time?
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