2017 School Supply Nomination

Member to be nominated's Name:*
Member to be nominated's Address:*
Member to be nominated's Phone Number:*
-
Member to be nominated's Employer Name & Location:*
Please list member's children, gender of each child, school name, and grade attending in Fall 2017. Also, please provide a brief description of why you nominated this member, and her children:*
The above member was nominated by:*