Dancing with the Tri-Cities Stars Dancer Nomination Form

Please fill out this survey entirely for the individual you are nominating.

Keep in mind when nominating a STAR:

We are looking for local "Stars" to participate in our fundraiser "Dancing with the Tri-Cities Stars" to benefit SteppenStone Youth Treatment Services. Our definition of a "Star" is someone in our community that has shown through their actions and attitude a love for helping others and being involved in the heartbeat of making our community a better place to live.

This event is a FUNDRAISER. Our yearly stars not only compete by dancing, but for their personal fundraising efforts.
This is a time investment. Most of our dancers will practice 1-3 times per week during the months April- June. These practices can be scheduled at any time to fit the dancer's work and family schedule.
All nominations will be considered and voted on by our committee. Please know we receive a large number of nominations each year.

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* 1. Nominator Information

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. Nominee Information

Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 3. Employer and Job Title of the Nominee:

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* 4. Provide any family information you would like us to know about the nominee:

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* 5. Please describe the nominee's community involvement. Include any clubs and organizations the nominee is involved in.

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* 6. Please describe any hobbies or other reasons you believe your nominee would be a good fit for our fundraiser.

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* 1. Nominator Information

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* 2. Nominee Information

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* 3. Employer and Job Title of the Nominee:

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* 4. Provide any family information you would like us to know about the nominee:

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* 5. Please describe the nominee's community involvement. Include any clubs and organizations the nominee is involved in.

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* 6. Please describe any hobbies or other reasons you believe your nominee would be a good fit for our fundraiser.

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* 7. PLEASE PRESS THE BLUE "DONE" BUTTON BELOW AFTER YOU HAVE UPLOADED THE NOMINEE'S PHOTO TO SUBMIT NOMINATION!!!!!!!!