2022 Adopted Family Nomination Form
Each year CMM Cares brings the business community together to support our neighbors and improve the quality of life, one family at a time, through our Adopted Family initiative. CMM Cares will choose at least one family in our community facing unexpected challenges that we can help support in 2022.

To nominate a family for the Adopted Family program, complete the below information. Please only make nominations for families that you have a relationship with and know the extent of their struggles. Challenges that nominated families may face include death or illness of a family member, medical challenges, etc. We request as much information as possible on this form to determine if they are a good fit for our program. Please note that to be eligible the nominated family must live within Suffolk or Nassau County, and we may ask for supporting documentation.
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Your Name (First & Last) *
Your Email *
Your Phone number *
Nominated Family Information
Please provide the names of each family member (First and Last), Gender, Ages of Children, and Family Relation. (example: Ava Smith, Female, 6 years old, daughter)
Family Member Names & Descriptions *
Nominated Family Address *
Nominated Family Contact Email *
Nominated Family Contact Phone number *
Connection to You *
The Family's Story
Please provide a thorough description of the family you are nominating detailing the situation this family is facing, how will the support of CMM Cares affect this family, and what are some of the biggest challenges they are currently facing?
About the Nominated Family... *
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