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The Third Place for Kids Membership Scholarship Nomination

Nominate a family to receive a 3-month membership to our inclusive community space

Nominator Information

What is your relationship to the family that you are nominating? (Check all that apply)

Family Being Nominated

email preferred

How did you hear about this program?

To ensure fairness, nominees will be contacted to provide additional details before the final selection process.

Would you like to remain anonymous, or would you like the family to know you nominated them?
I would like to remain anonymous
I would like the family to know I nominated them
Would you be willing to provide additional details if needed?
Yes
No

Agreement & Next Steps

By signing below, I confirm that:


The information provided in this nomination is accurate to the best of my knowledge.


I have read and agree to the Terms & Conditions of The Third Place for Kids Scholarship Program.


I understand that the nominated family will be contacted to complete a follow-up form before final consideration.


I understand that providing false or misleading information may result in disqualification.

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