Style For Success Nomination Form
We are excited to share a new initiative launching through Casa Lucerito called "Style for Success". This is a monthly wardrobe and confidence-building opportunity for women in our community. Please fill in the form below accurately and ensure you include nominee name and contact details.
Nominator:
Person submitting the nomination
Full Name
*
First Name
Last Name
Company / Organization
Position / Role
E-mail
*
example@example.com
Phone Number
*
Format: (000) 000-0000.
Will the nominator or other members of the organization be attending the styling session?
*
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Nominee Information
Please indicate details about your nomination
Why are you nominating this individual for Style for Success?(Please describe how this opportunity would support her goals, confidence, or next steps.)
*
Are there any comfort considerations we should be aware of (sensory, interaction style, physical, social, emotional, etc.) ? All comfort considerations are optional and shared only to help us create a supportive, welcoming experience. Providing this information will never affect eligibility or selection.
*
Is there anything else you’d like us to know to help make this experience a success?
*
Nominee Phone Number
Format: (000) 000-0000.
Nominee Email
example@example.com
I confirm the following (Check all that apply)
Nominee is 18 years or older
The Nominee is a resident of Dona Ana County
Nominee agrees to photography and use of images and story for marketing purposes
The Nominee is able to attend on the last Thursday of the month Between the hours of 11:30am - 1:00pm
Nominee understands outfits are limited to clothing only
I confirm that the nominee is aware of this nomination and has agreed to participate if selected.
Yes
Signature
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
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