FCC Dollar Club Nomination Application
Thank you for nominating yourself or another person for the FCC Dollar Club in order to create a movement of outrageous and contagious generosity in Hernando County. The following form must be completed to be considered. All lines marked with a *must be filled out. Please provide as much detail as possible.
* Required
For whom are you filling out this application?
*
Yourself (C-19 Response- $200 Gift Card for food or gas)
Another Person (C-19 Response- $200 Gift Card for food or gas)
Outstanding Needs Beyond Program (Will take more time due to being considered case by case)
How did you hear about the FCC Dollar Club and C-19 Response?
*
Your answer
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms