Thank you for your nomination! Please fill out the information below with THEIR INFORMATION: Name * First Name Last Name Email * Phone (###) ### #### Military service - Put NA if not available * Employer Information * Their employer phone # ESTIMATED INCOME * ESTIMATED DEBT: * DOES THE FAMILY OWN A HOME: * How did you hear about us? Option 1 Option 2 Message * Their home address * HAVE ANY MEMBERS OF THE HOUSEHOLD EVER BEEN CONVICTED OF OR BEEN CHARGED WITH A CRIME? (IT COULD BE AS SIMPLE AS A MISDEMEANOR DRIVING VIOLATION OR AS SERIOUS AS ARMED ROBBERY.) WE DO EXTENSIVE BACKGROUND CHECKS. * HAS THE FAMILY OR ANYONE IN THE FAMILY BEEN INVOLVED IN A LAWSUIT? * HAS THE FAMILY OR ANYONE IN THE FAMILY FILED FOR BANKRUPTCY? * HAVE ANY MEMBERS OF THE HOUSEHOLD BEEN ON TELEVISION? * DOES ANYONE IN THE HOUSEHOLD HAVE A FACEBOOK, BLOG OR WEB SITE OF ANY KIND? * HAS ANYONE IN THE HOUSEHOLD PARTICIPATED IN VOLUNTEER WORK OR COMMUNITY SERVICE OF ANY KIND? * HAVE ANY HOUSEHOLD MEMBER'S ACHIEVEMENTS OR PROUDEST ACCOMPLISHMENTS BEEN RECOGNIZED BY YOUR COMMUNITY? * LIST ALL VEHICLES OWNED AND OPERATED BY HOUSEHOLD MEMBERS (INCLUDING YOUR OWN): * If you are nominating SOMEONE ELSE, please put your contact information below: FIRST AND LAST NAME * EMAIL: * PHONE: * ADDRESS: * Family Story SUMMARIZE THE FAMILY'S CURRENT SITUATION. WHAT MAKES THEM DESERVING? WHAT MAKES THE SITUATION UNIQUE? * Thank you SO MUCH for nominating someone, we will be in touch soon!
