Stars and Stripes Charitable Alliance Gift for Grannies, Grampas and Retired Vets

Stars and Stripes Charitable Alliance Gift for Grannies, Grampas and Retired Vets

Nomination Form
Please complete this information for the senior citizen or retired veteran that you would like to nominate to receive a gift during the upcoming holiday season:
Name
Address
City
State
Zip
Phone Number
Tell us something about the granny/grampa/vet you are nominating! Any information you can provide would be greatly appreciated.
Special Interests?
Clothing Size?
Shoe Size?
Favorite Color?
Please provide your information should we need to contact you to coordinate this gift:
Nominators Name
Phone Number
Email Address
example@example.com
Thank you very much for nominating this Senior in Need!
Do you have any comments you would like to add?
Should be Empty: