Nomination Form For Trucking Family In Need

To apply for benefits from Trucker’s Christmas Group we will need some information.

If you are applying for yourself please also upload a picture of your CDL

Please fill out the form completely.

Nominees must be a legal resident of the US or Canada.

All information gathered is held in house and not shared with the public unless express permission is given.

NOMINATIONS FOR THE 2023 SEASON ARE NOW OPEN AND WILL CLOSE AT 23:59 ON DECEMBER 19th 2023. WE RESERVE THE RIGHT TO STOP ACCEPTING NOMINATIONS AT ANY TIME. SO PLEASE GET THEM IN EARLY

Nominee Information

Name of family needing assistance *
Address of Nominee
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Main Phone Number of Nominee *
Secondary Phone Number for Nominee
Email of Nominee
Nominee's facebook page Please enter the URL here. Make sure to include "http://" or the form will give you an error on submission
Upload a Copy of the Nominee's CDL If Possible And Only Do It With There Consent

Family Information

Adults 18+
12yrs to 17 yrs
6yrs to 11 yrs
Infant to 5yrs

Why are you nominating this Trucking Family?

What is your relationship to the trucking family you are nominating? *
SpouseParentChildBrother/SisterOther family memberFriendCo-WorkerEmployerOrganizationOther
Explain in detail the circumstances on why the nominee needs assistance. Please be as descriptive as possible, the more information we have the better we will be able to help. *
If you would like to make a short video (less than 5 minutes) to go along with your written application, you can do that here. Upload your video to the webservice of your choice and enter the link to the video here. Please enter the URL here. Make sure to include "http://" or the form will give you an error on submission
Is the nominee a Truck Driver? *
YesNo

Nominee's Connection To The Trucking Industry

If the Nominee is not a Truck Driver what is there occupation?
Current Employer
Former Employer
How Many Years in the Trucking Industry? *
Company Driver or Owner Operator *
Company DriverOwner OperatorDon't Know
To the best of your knowledge has the nominee or any of there immediate family received assistance from TCGO in the past? *
YesNoUnsure

Your Contact Information

Name *
Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Main Phone Number *
Alternate Phone Number
Email *
Do you wish to remain anonymous to the family you're nominating? *
NoYes
How did you hear about us? *
By clicking submit you attest that all entries are true and correct. If at anytime during our investigation we find circumstances that are not 100% true and correct as entered on this application it could mean automatic refusal of your application.