Nomination Form - Spreading Joy for Senior Citizens

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Please submit the information of individuals with whom you want to spread joy!

Our team of volunteers will create hand-curated care packages and deliver them to the first 20 nominations we receive through this form. We will give you a call when we are at your nominee's residence to spread the joy we are creating for those aging in place along the West Colfax corridor!

Working together to ENERGIZE historic West Colfax

Senior Citizen - Nominee's Name
*

Senior Citizen - Nominee's Address
*

What time can your nominee receive visitors? (Monday - Friday)
*

AM (8a - 12pm)

PM (12pm - 6pm)

Full day

What kind of care package would your senior citizen enjoy best? If no selection is made we will provide a care package based on availability of materials.

General - includes a selection of treats, small crafts, some stationery materials, etc.

Old School Cool - includes stationery materials & stamps for writing letters, jigsaw puzzles, etc.

Sweet Tooth - includes yummy treats, candy, coffee, etc. from local vendors

Clear selection

Please share the reason(s) why you are nominating this senior citizen to receive a care package

Your Name *

Would you like us to call you when we deliver the care package to your nominee?
*

Yes, please! I want to share in the spreading of joy

No, thank you. I'd like to stay anonymous

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