Our Hands: Nomination Form
Nominate yourself, or someone you know that could really use our help! 

All nominations will be kept confidential among administrators of our group. We will contact you shortly after receiving your form. Not all nominations will be able to be helped all the time, but we will do our absolute best to try and help and will reach out to you regardless. 
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Nominating yourself or someone else? *
Name of Nominee: *
Nominee Email: *
Nominee Phone Number:  *
Nominee Address (Including City):  *
Name of Person Submitting Nomination: *
How many people live in the home? *
Do any pets live in the home? If so, how many and what kind? *
Roughly, how many square feet is the home? *
How many stories is the home? *
Tell us what is going on! (The more details, the better) *
What can we help with? (Select top 5): *
Required
You agree upon 'electronic signature' of this form to hold harmless ALL members of the volunteer team and 'our hands' volunteer group while in your home and assisting with your needs.  *
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