First name
Last name
Email
Mobile
1.
What is your relationship with the nominee?
2.
Who are you nominating?
3.
Nominee's neighborhood
4.
Nominee's zip code
5.
Nominee’s Email Address
6.
Nominee's phone number
7.
Why should they be an ambassador for their neighborhood?
8.
How are they currently involved in their community?
9.
What makes them stand out as a leader or connector?
10.
Anything else you’d like us to know?
11.
Consent
I confirm that the nominee is aware of this nomination or would be open to being contacted by Move Detroit.
I agree to be contacted by Move Detroit regarding this nomination