Freedom Quilters Nomination Form

Nomination Form for Freedom Quilter Recipient

Nominee Information

Name(Required)

First Last

Email(Required)

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Reason for Nomination(Required)

Please provide a detailed explanation (200-500 words) of why you believe this individual deserves to be nominated for the Freedom Quilter Award to present them with a quilt honoring their recovery journey. Include any relevant details about their recovery journey, their resilience, strength, and the impact they’ve had on others around them

Your Information (Nominator)

Name(Required)

First Last

Email(Required)

Phone(Required)

Relationship to Nominee(Required)

Date of Submission(Required)

By submitting this form, I confirm that the information provided is accurate to the best of my knowledge and belief. I understand that incomplete or inaccurate information may affect the consideration of this nomination

Signature

Please submit the completed form to Serenity Recovery Connections Attn: Scott Beaver/Freedom Quilters