NOMINEE INFORMATION
* Name of family needing assistance:
>DaElf
Nominee's address — Street:
>
Apt, Suite, Bldg. (if any):
>
City:
>North Pole
State / Province / Region:
>Ak
Country:
>USA
* Main phone number of nominee:
>1800Santa
Secondary phone number of nominee:
>
Email of nominee:
>Bernard @Santa.com
Nominee's Facebook page (full web address, starting with http://):
>
Nominee's CDL: if you have a copy and the nominee has said it's OK,
please attach a photo of it to your reply. (Write "attached" here if
you did):
>
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FAMILY INFORMATION
Number of adults 18+ (pick one: 0, 1, 2, 3, +3):9
>
Number of children 12 to 17 yrs (pick one: 0, 1, 2, 3, 4, 5, 6):9
>
Number of children 6 to 11 yrs (pick one: 0, 1, 2, 3, 4, 5, 6+):9
>
Number of children infant to 5 yrs (pick one: 0, 1, 2, 3, 4, 5, 6+):9
>
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WHY ARE YOU NOMINATING THIS TRUCKING FAMILY?
* Your relationship to the family (pick one: Spouse, Parent, Child,
Brother/Sister, Other family member, Friend, Co-Worker, Employer,
Organization, Other):
>
* Explain in detail why the nominee needs assistance. Please be as
descriptive as possible — the more information we have, the better
we will be able to help. (Write as much as you need.)
>Santa's sick and I'm struggling to make Christmas happen
>
>
Video link (not required): if you made a short video (under 5
minutes) to go with this nomination, put the link here — full web
address, starting with http://:
>
* Is the nominee a Truck Driver? (Yes or No):
>
Yes
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NOMINEE'S CONNECTION TO THE TRUCKING INDUSTRY
If the nominee is not a Truck Driver, what is their occupation?
>Sleigh driver
Current Employer:
>Santa Enterprises
Former Employer:
>Frosty's Brothel and Emporium
* How many years in the trucking industry? (pick one: 1-5, 5-10, 10+):
>199
* Company Driver or Owner Operator? (pick one: Company Driver,
Owner Operator, Don't Know): Company
>
* To the best of your knowledge, has the nominee or any of their
immediate family received assistance from Truckers Christmas Group
in the past? (pick one: Yes, No, Unsure):
>
No
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YOUR CONTACT INFORMATION
* Your name:
>Bernard
City:
>North Pole
State / Province / Region:
Ak
* Do you wish to remain anonymous to the family you're nominating?
(pick one: No, Yes):
>Yes
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