Project Love in a Box Nomination Form
Do you know any child going through hard times this period?
Please nominate in the form below.

N.B: The nomination form is applicable to a child between ages 2-15.
First Name *
Last Name *
Age(2-15) *
Address *
Parent/Guardian Name *
Parent/Guardian Phone number *
Parent/Guardian Email
Name of the Nominator *
Phone number of the Nominator *
Email Address of the Nominator
Why are you nominating the child(ren) in at most 200 words *
Submit
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