Please complete this form by April 15, 2024 at 11:00pm EST to submit your official nomination.

Five (5) winners will be selected at random to receive a giveaway package including:
🟣 A journal from Dear Black Girls &
🟣 A mug from An NYC Kid

NOMINEES MUST BE:
🟣 10 - 12 years of age
🟣 A resident of one of the five NY boroughs
🟣 Identify as a woman of color

NOMINEES MUST NOT BE OF FAMILIAL RELATIONSHIP.

Note: If nominee is part of a protected group and information needs to remain confidential please utilize the agency contact information.