2017 Giraffe Award Nomination Form
Your Information
Please provide your information below.
Name *
Your answer
Company/Organization
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Email Address *
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Phone Number *
Your answer
Nominee Information
Please provide contact information for your nominee below.
Nominee Name *
Your answer
Nominee's Company/Organization *
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Nominee Email *
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Nominee Phone Number *
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Nominee Address
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Which of the following, is your candidate?
Select the Award Category. *
Why does your candidate deserve a Giraffe Award? *
Your answer
Give us a specific example of when your candidate "stuck their neck out" for Maine Kids? *
Your answer
Why/how does your candidate inspire your or others to act for Maine Kids? *
Your answer
Additional Comments
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