Story Nomination Form
Share who you’re nominating and describe their story, impact, and the media support you think would help.
Nomination Information
Who is being nominated?
*
Myself
Individual
Business / Entrepreneur
Church / Faith-Based Organization
Nonprofit / Community Organization
Creator / Podcaster
Author / Educator / Expert
Community Program / Initiative
Other
Nominee name
*
Business or organization name
City and state
*
Website or social media
Your Information
Your Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to the Nominee
*
Please Select
Self
Family / Friend
Customer / Client
Community Member
Business Associate
Church / Ministry Connection
Organization Representative
Other
Tell Us the Story
Tell us about the nominee and their story
*
Why should this story be considered for the CTRMN Community Giveback Initiative?
*
What impact are they making?
*
How could media support help?
*
Additional Information
Is there anything else we should know?
Upload supporting materials
Upload a File
Drag and drop files here
Choose a file
Cancel
of
How did you hear about the CTRMN Community Giveback Initiative?
*
Please Select
CTR Media Network Website
CTR Media Network TV
Facebook
Instagram
LinkedIn
YouTube
TikTok
Search Engine
Friend / Referral
Church / Community Organization
Event
Other
Required acknowledgment
*
I acknowledge that the information provided is accurate and complete to the best of my knowledge.
Communication consent
*
I consent to receive communications regarding this nomination and related program updates.
NOMINATE A STORY
Should be Empty: