2017 Giraffe Award Nomination Form
Your Information
Please provide your information below.
Name
Your answer
Company/Organization
Your answer
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
Your answer
Nominee Address
Your answer
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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