Filipino Holiday Health Hamper Nomination Filipino Holiday Health Hamper Nomination I am nominating: * myself someone Does the recipient reside in Saskatoon or the close surrounding area? * Yes No Name of Recipient (person who is receiving the hamper) * Name of Recipient (person who is receiving the hamper) First First Last Last Phone Number of Recipient * Email of Recipient (if available) Is the recipient aware they are being nominated? Yes No For any further information, who should we contact? please contact me please contact the person I am nominating Who will be picking up the hamper? the recipient myself or someone else What date do you prefer to pick up? *Please note that if the hamper is not picked up on the scheduled day it will not be held for you and may be given to the next person in need. * December 15th: 9am – 4pm December 16th: 9am – 4pm December 17th: 9 am – 4 pm Please provide your contact information: * Please provide your contact information: First First Last Last Phone number: * Would you like to leave a message for the nominated person? ( a paper copy will be included in their hamper ) If you are human, leave this field blank. Next