Nomination Form

Blended Health & Smoothie Bar is an establishment rooted in kindness, and because of this we choose to celebrate those that share this same value.

We look to recognize individuals that express inherent kindness while expecting nothing in return. Our Blended Family Member of the Month program celebrates individuals that show kindness to others, either on a daily basis, or through an expressed act. These individuals can be nominated by their family, friends or peers as someone who deserves recognition for doing their part to spread kindness.

We will accept rolling submissions, which means you can nominate ANYONE at ANYTIME and they will have a chance to be highlighted as the Blended Family Member of the month.  We will put their picture on the Family Tree Wall alongside the submission, and both the winner and the individual that nominated them will win $20 in Blended Bucks!

Fill out the information below, tell us why you are nominating this person.  Did they do something amazingly kind?  Are they always doing nice things for people?  Do they treat others with respect and are unaware of how awesome they are?  Tell us below.  We will reach out to you for a picture of the Nominee if they will be feature for the month.  #StayKind

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* 1. Your Contact Info (Nominator)

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* 2. Your Instagram Handle (if applicable)

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* 3. Nominee Contact Information

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* 4. Nominee Instagram Handle (if applicable)

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* 5. Paragraph of nomination: (why are nominating this person)

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