Prom With A Purpose Nomination Form 2023

Prom Court Nomination Form

Nominate someone you know who has compassion for others, is community-minded and competitive to the 2023 Prom with a Purpose King and Queen’s Court.
What is Prom With A Purpose?

Visit www.kcshepherdscenter.org/prom to learn more about Prom With A Purpose!
Nomination Information:

These individuals should be well-connected in their respective communities, represent diversity in age, gender and race, and have a relentless passion for raising funds to support and shine a light on issues facing the older adult population. Selected members of the court will participate in a 13-week fundraising campaign to provide services to older adults, celebrating their contributions to the community and providing support and companionship to increase social activity, reduce food insecurity and build lasting relationships.

You may nominate the candidate of your choice or if you think you might be a good candidate, you can nominate yourself.

Do you know an AMAZING candidate who should be nominated??

Nominate them by filling out the form below.

Nominations are open March 15th, 2023 - April 30th, 2023
The 2023 court will be announced in the first part of May and voting for the court candidates will be open on July 1st, 2023.
Candidate First Name
Event Information

September 30th, 2023: Prom With A Purpose

Event Venue:

HyVee Arena
1800 Genesse St
Kansas City, MO 64102
1. Nominee Information
Candidate Last Name
Candidate Age Range

60 +59 -
Why would this person be a good candidate for the Prom Court?
If selected "other" on the above question, please provide more detail here.
Candidate Phone Number

Area CodePhone Number
Candidate E-mail Address
example@example.com
Candidate current or past company/business name
Candidate current or past job title
Is the candidate aware they are being nominated?

YesNo
Your Relationship To The Candidate
2. Nominator/Your Information
Your First Name
Your Last Name
Your Phone Number

Area CodePhone Number
Your E-mail Address
example@example.com
Before submitting, please be sure all fields are complete. Incomplete nominations cannot be reviewed.
Questions?

If you have questions, please contact Terri Goddard, Director of Resource Development and Community Outreach, KC Shepherd's Center at 816-293-9614 or email terri@kcshepherdscenter.org .
Thank you!
Should be Empty:

Prom Court Nomination Form

Thank you!