Please provide all of the following information to recognize an employee or volunteer who went above and beyond the call of duty in the name of kindness.

Nominee’s first name ­­ *

Email address of nominee­­ * (this will not be published anywhere)

Nominee’s Place of Employment ­­ *

Describe the nominee’s exceptional service and/or kindness ­­ *

Check this box to permit us to publish this info on our website and possibly in other promotional materials.

Part 2 (optional)

If you wish to be identified to your nominee, please provide the following information about yourself (this information will not be published on our website):

Your name ­­

Your email address ­­