Enter Your Name
Enter Your E-Mail Address
Enter Your Telephone # (optional) Enter Your State

Enter Name of Nominee

Nominee is Their Country State
Your Relationship to Nominee If 'Other', please explain (optional)

Please describe why this person is a Special Hero

How Can We Contact This Person? (If you know how we can.)

If you know of an article regarding this person, already on the Internet, please give us the website/s


We ask that you send us by email or US mail service any other documentation that you want us to have, of this hero's efforts,
By email, simply send them to us as attachments, when sending this form. Or, send to:
By US mail, send to: Nominations, Special Heroes, PO Box 603002, Providence, RI 02906