Nomination Form

Thank you for your interest in nominating someone for the “Dollar Project.” As you can imagine, the number of requests received each month is simply overwhelming. There are so many people in need, which means there are many opportunities for all of us to be the hands and feet of Jesus in someone else’s life. The following application is required for consideration by the Dollar Project. Please complete all questions as indicated below and click the "submit" button. Please note, if you have already submitted information and are receiving this application to fill out, you need to re-submit that information with this application.

Following receipt of your application, you will not be contacted again unless additional information is needed to process the application.

We respectfully ask you not to contact anyone on our staff regarding the decision-making process or status of your request. In general, those whose requests are chosen by the committee will be contacted within two weeks. If you don’t hear back from us within that time period, it is likely that we’ve been led to assist another candidate.

Nominee First Name. (This Needs to be their Legal Name)

Nominee Last Name. (This Needs to be their Legal Name)

Spouse's Frist Name. (This Needs to be their Legal Name)

Spouse's Frist Name. (This Needs to be their Legal Name)

Has this person been nominated before? YesNo

If yes what was the original application date?

Marital Status (Required)

Names and relationships of any other adults living in the household.
Please include first and last names and relationship- one per line.

Children
Please list any children living with the nominee -one per line. None? Just say N/A

Does the applicant attend church? if yes where?
Please know that this does not affect the decision for receiving Dollar Project funds.

Nominee Contact Information

Nominee Phone (required)

Nominee Email (required)

Nominee Street Address (required)
City (required)
State (required)
Zip (required)

Nominee Contact Information

Immediate Financial Need (required)
Provide specifics about amounts owed, to whom it's owed, etc. The more information provided, the better we will be able to understand the need.

Overall Life Situation (required)
Provide specifics as possible in describing the overall situation that has caused the nominee to be in their current financial state.

How would a Dollar Project gift make a lasting change in the life of the recipient? (required)

Your Information
Please provide the following information about the person submitting this application. If you are submitting an application for yourself, please type "self" in the "relationship to nominee" field.

Your First Name (require)

Your Last Name (require)

Relationship to Nominee (require)

Are you a member of or attend Okolona? (require)

Your Email (require)

Your Phone (require)