Awards Nomination Form

Tell us about someone who started a Wave of Kindness for you this week. Someone who inspired you. Maybe they did something for others? Tell us. We will choose one weekly winner and give them $104 powered by our friends at College of Health Care Professions and Wild 104, as part of paying it forward! Who was your Wave of Kindness Starter this week?

1. Wave of Kindness starter Information
Wave of Kindness starter, Name

First NameLast Name
Wave of Kindness starter, Phone Number

Area CodePhone Number
Wave of Kindness starter E-mail Address if known
What other information do you have to contact the Wave of Kindness Starter?

3. Your Information
Your Name

First NameLast Name
Your E-mail Address
Your Phone Number

Area CodePhone Number
Your Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
What did they do to start a Wave of Kindness?
Should be Empty: