The scrub hub

The scrub hub

Free Mental Health Clean Nomination form
The Scrub Hub - Free Mental Health Clean Nomination

The Scrub Hub offers one FREE clean to someone who truly deserves a helping hand. Please complete the form below to nominate yourself or someone else. All nominations are kept confidential.
Your full name
Your Email
example@example.com
Nominee Full Name
Nominee contact number or Email
Are you nominating yourself or someone else?
Special Circumstances
Nominee Address/Area
Must be local - Dagenham and surrounding areas
Why do they deserve a free clean
In a few words tell us why you think this person should receive the free clean.
Would you like to remain anonymous?
Can we contact the nominee directly?
Permission to share winners story?
Thank you for your nomination! Winners are announced monthly via text/email.
Should be Empty: