Power of $1 Nomination

Guidelines:

1. This program is designed to help individuals or families not organizations or ministries.

2. Our practice is to make payment to a vendor or a bill rather than give the money directly to an individual. We can also purchase a needed item directly.

3. We will generally only give one (1) gift per individual or family during the year.

4. If your nomination isn’t selected, you are free to resubmit the nomination.

Power of $1

Date Of Nomination*

Nominee's Information

Name of Person with the need?*

Email Address for Person with Need

Phone Number for Person With Need( ) -

What is the best time to reach them?

To your knowledge, has the person been nominated before?*

Yes

Do they actively attend Impact?*

Yes - Moon Campus

Not Sure

Describe the need: (Please be specific about the need and if possible the dollar amount needed.) *

How would a gift from the Power of $1 make a lasting difference in the life of the recipient?*

Your Information

What is your name?*

What is YOUR email address?

What is YOUR Phone Number?( ) -

What is the best time to reach you?

Your relationship with the Person: (friend, family, coworker, etc)

Is it okay for us to tell the person that you nominated them?*

Yes

Do you actively attend Impact? (This is not a requirement to nominate someone.)

Yes - Moon Campus

Please leave this field blank.