2025 Hear for the Holidays
Ho Ho Holidays Hearing Aid Giveaway Application
Information of Nominating Party:
Full Name
*
First Name
Last Name
Phone Number
*
E-mail
example@example.com
Relationship to the Nominee:
Information about the Person you are Nominating:
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Date of Birth
-
Month
-
Day
Year
Date
Does your loved-one have unilateral or bilateral hearing loss?
What type of amplification are they using currently?
Please tell us about the person you are nominating. What makes them special? What challenges have they overcome? Why should we gift them a pair of hearing aids?
Submit
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