Smiles for Seniors Umbrella Awards Nomination Form
Do you know someone who is always
doing something nice for you or for others?
Someone who goes out
of their way to help a stranger, gives the shirt off their back, Lends a hand?
We are looking for great stories about those special people who do extraordinary things for others.
Nominees will receive a dinner ticket and a special award at the event April 25th
just for being nominated.
Submit your entries by mailing or emailing 200 words or less about the person you wish to nominate
to Smiles 4 Seniors "Umbrella" P.O. Box 1113 Yucaipa Ca 92399 or email at email@example.com
Service- First Responders, Fire, Police, Nurse, Teacher
Any one person who does good deeds
Non Profit Organization- Church, Charity, Non Profit Organization
Responsible companies who give back to the community
YOUR Phone ______________________________YOUR
Nominations must be received by April 12th
Nominations must be received
by 4/12/2020 Umbrella Award winners will be chosen by an outside panel of judges who will determine one winner in each category.
Nominees and nominators names, stories and photos may be used in the media and on the Smiles for Seniors website. Nominees
and their nominators will be notified by mail. All nominees will receive an award. Winning nominee will be announced at the
award show. You do not have to be a senior to nominate, win, or attend the awards dinner. Children under the age of 18 must
be accompanied by an adult,. Group party tables are available All proceeds will benefit local low income seniors in need.
Please visit our website at www.smiles4seniors.org or call (909) 790-6671 for more info. Smiles for Seniors may update the
rules as needed