One moment please...
Nominate
I am nominating myself or someone else for:
*
For Which Program Are You Nominating Someone?
A Cancer Mission Sail
A Healthcare Heroes Sail
Your Contact Information (As the Nominator)
Nominator Contact Name
First Name
Last Name
Nominator Contact Address
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Nominator Email
*
Verify Email
*
Nominator Cell Phone
Nominator Home Phone
I am nominating myself
*
Yes
No
Nominee's Contact Information
Nominee's Name
First Name
Last Name
Nominee's Address
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Nominee's Email
Verify Email
Nominee's Cell Phone
Nominee's Home Phone
Would you prefer to be an 'angel' nominator or remain anonymous?
*
Anonymous - please don't share that I nominated them
Angel- please let them know that I would love to have them go sailing!
Alternate Contact Person for Nominee
If we should not call Nominee directly, please provide contact information for an alternate person.
A summary of why you are nominating this person
*
Please let us know the story behind the nomination; why you feel that you, your friend/loved one(s) and their caregivers would be a good candidate for a sail with us on Lake Champlain.