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Santa for seniors form

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  • 1. -NOMINATION FORM "S-ANTX FOR-SENIORS" -~ Accolade " 0 M E C A. R £Name of Nominee: -------------------------------------------------------Nominated by: _Will this person be spending Christmas alone? __Have they recently suffered a loss or had a set-back in health? _Will this person be open to visitors or hesitant? _Would you ca II this person relig ious? _Do you know of any special Christmas traditions this person has celebrated in the past?What else should we know about this person to better serve them and celebrate with themthis Christmas season? --~------------------------------------------~----What is the physical address of this person? -- _What is the phone number of this person? ~ _May we tell them that yOlJ sent us? ~ _ ALL NOMINATIONS MUST BE TURNED IN BY NOVEMBER 30TH•

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