Nominee Information
Person Being Nominated
Nominee Full Name
*
First Name
Last Name
E-mail (if known)
example@example.com
Nominee Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Service Category
*
U.S. military veteran
Active-duty service member
First Responder
Other
Branch of Service or Agency
*
example@example.com
Years of Service
*
example@example.com
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Nominator Information
Person Submitting the Nomination
Your Full Name:
*
example@example.com
Phone Number
*
E-mail
*
example@example.com
Home Phone Number
Home & Roof Information
If known, helps with screening
Approximate Age of Roof
Any Known Issues?
Does the nominee own a home?
*
Please Select
Yes
No
Unsure
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Essay Section
Please explain why this veteran or first responder deserves to receive a free roof.
Tell us more about your hero:
You may include details about their service, hardships, acts of community support, and how receiving a new roof would positively impact their life.
Attach photos of the home (if available):
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