NCW Cancer Heroes Honoree Nomination

NCW Cancer Heroes Honoree Nomination

Let us honor a Cancer Hero on your behalf, to be celebrated at the North Central Washington Cancer Heroes event!
Step 1: About the Honoree
The information you provide here will be shared publicly. Please do not include confidential and private information. We acknowledge that we are sharing vulnerable stories, and we strive to do so with the utmost respect and compassion. Thus, we reserve the right to reach out to your Honoree or a Representative to confirm the information being shared.
1. Name of Honoree/s (as it should be publicly recognized):*
2. Which category best describes your Honoree?*

Cancer Warrior/s - includes those in treatment, living with cancer, and survivorsChampion/s - includes caregivers, loved ones, providers, and support systemsTribute/s - honoring those who are no longer with usOther
3. The Honoree is:*

An individualA coupleA group of peopleA business or organizationOther
4. Provide a short synopsis on why this Honoree is a Cancer Hero from your perspective:*

0/500
5. Please provide up to 3 photos of your Honoree. Include at least one photo of only the Honoree/s (not including anyone else) or the Business/Organization logo. Upload here or contact event@wellnessplacewenatchee.org to provide photos.

Cancelof
6. Where did you source the provided photo(s)?
7. All of our nominated Heroes will be recognized publicly. To the best of your ability, what level do you believe your Honoree is comfortable sharing their story?*

Low-key - minimal public attention, this is a personal thank youAverage - whatever the group of Honorees receivesAbove Average - they like sharing their storyI have no idea
Step 2: Honoree/Representative Contact Information
Honorees will receive a notification from Wellness Place that they have been nominated as a 2025 NCW Cancer Hero and receive one complimentary ticket to the event at which all of our Heroes will be honored. If for any reason we cannot contact the Honoree, we will reach out to a Representative on their behalf.
8. Who should we contact to notify about this nomination? (select all that apply)*

The HonoreeThe RepresentativeMe, the Nominator
9. Honoree's email address:
example@example.com
10. Honoree's phone number:
Please enter a valid phone number.
11. Honoree's mailing address:

Street Address

Street Address Line 2

CityState

Zip Code
12. Please provide the name of a Representative that we may contact on the Honoree's behalf:

First NameLast Name
Business/Organization (optional)
13. Representative's relation to the Honoree:
14. Representative's email address:
example@example.com
15. Representative's phone number:
Please enter a valid phone number.
16. Representative's mailing address:

Street Address

Street Address Line 2

CityState

Zip Code
Step 3: Nominator Information
17. Name of Nominator/s (as it should be publicly listed):*
18. Your Name:*

First NameLast Name
19. Your relation to the Honoree:*
20. Your email address:*
example@example.com
21. Your phone number:*
Please enter a valid phone number.
22. Your mailing address:*

Street Address

Street Address Line 2

CityState

Zip Code
23. What personal message would you like to share with the Honoree/Representative?*

0/500
24. Is your message private for the Honoree/Representative only, or may we display it at the event?*

My message is privateMy message may be displayed
Step 4: Donation Payment

My Products*

Honoree NominationEnter description

$120.00

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Other Information
Is there anything else we should know?

0/500
Should be Empty:

NCW Cancer Heroes Honoree Nomination

Step 1: About the Honoree

Step 2: Honoree/Representative Contact Information

Step 3: Nominator Information

Step 4: Donation Payment

Other Information