Nominate Single Mother

Nominate a single mother in a low income household who needs either financial assistance or childcare help due to the Covid Crisis.
1.Your Name
2.Your Email
3.Your Phone Number
4.Nominee Name
5.Is the nominee a single mother?
6.Is the nominee in a low income household?
7.What does the nominee need (check all that apply)?
8.Where does the nominee live (city, State)
9.How do you prefer to be contacted?
10.How do we contact your nominee?