She IS ME — Woman Nomination Form
Sponsored by Kim Powell & Co.
She IS ME is a short film project highlighting the real stories of women throughout Hampton Roads their journeys, resilience, accomplishments, and impact. Nominate a woman whose story deserves to be seen, heard, and celebrated.
Your Full Name
*
First Name
Last Name
Your Email Address
*
example@example.com
Your Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Nominee's Full Name
*
First Name
Last Name
Nominee's Email Address or Phone Number
*
This will only be used to contact her regarding the project.
What Hampton Roads city does she live in?
*
Please Select
Chesapeake
Hampton
Newport News
Norfolk
Portsmouth
Suffolk
Virginia Beach
Williamsburg
Other Hampton Roads locality
Why are you nominating her for "She IS ME"?Tell us briefly about her story and the impact she has made. You do not need to write an essay.
*
How do you know the nominee?
*
Does the nominee know you are nominating her?
*
Yes
No
No is okay. 757 We Care will contact selected nominees before any participation.
Submit Nomination
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