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* Your Name

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* Your Email

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* Your Phone Number

Recipient / Nominee Information

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* Name of Recipient / Nominee
(you can nominate yourself!)

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* City

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* State 
(nominee must be in Wisconsin or north-central Illinois )

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* What makes this person a good choice for a Work From Home office package?
What are the conditions that this person is working in today?
What would it mean to the recipient to receive a Work From Home package?
(250 words or less)

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* Do you have photos of the nominee's existing WFH space?  Upload them here!

PDF, PNG, JPG, JPEG file types only.
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