Holiday Streakers Recipient Nomination Form
Please provide the following information to be considered by our Nomination Committee as a potential recipient for Holiday Streaking 2021. Feedback from the committee is that more information is better when it comes to considering who gets chosen. See our website ( for more information about what Holiday Streaking is and our recipient page to read about past recipients. Happy Streaking!
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Recipient/Family Name
Location (City and State)
Recipient family email (only to be used by Holiday Streakers to contact the family if needed)
Please provide some information about the nominee or the nominee family (possible info could include family members, vocations, how you know them, hobbies they have, activities they enjoy, or anything else that would help the committee feel like they "know" the recipient/family).
Please provide specifics regarding the health/life issue this nominee/nominee family is facing and how this has burdened them financially (how the donation may be used to ease financial burden). Be as descriptive and thorough as possible.
What makes this nominee/family special to you? Why do you feel they would be a deserving recipient?
Does the nominee/family know you are nominating them as a potential recipient for Holiday Streakers?
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If chosen, is the nominee/family willing to have information regarding their challenges posted by Holiday Streakers on our Facebook page/group and website? We also encourage a CaringBridge-type blog site to keep Streaker Nation updated throughout the Streak.
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Additional Comments
Your name
Your email
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