Hearts & Halos Tree

Hearts & Halos Tree
Nomination Form
Thank you for nominating a child for the Hearts & Halo Tree program, which aims to bring joy and support to children under 17 during the holiday season. Please fill out the form completely to ensure we can provide the best possible experience for each nominated child.

Section 1: Nominator Information
1 Full Name
2 Relationship to Child
3. Contact Phone Number
Format: (000) 000-0000.
4 Email Address
example@example.com
Section 2: Child's Information
1 Full Name
Age
3 Gender
5 Favorite Color
TitlesAuthors
2. Toys/Games: Specific Preferences: 3. Clothing/Accessories: Styles/Items:

Section 4: Additional Information
Toys/Games: Specific Preferences: 3. Clothing/Accessories: Styles/Items:Section 4: Additional Information
Any special needs or considerations for the child
Is there anything else you'd like us to know about the child?
I consent to the collection and use of the above information for the purposes of the Hearts & Halos Tree program. I understand that this information will remain confidential and only be used to ensure a suitable gift is provided to the nominated child. Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Thank you for your nomination! We appreciate your support in making the holiday season brighter for children in need. Please submit this form by December 10, 2024 to ensure participation in this year's
Should be Empty:

Nomination Form