Nominations Form

Contact Information

Complete this form to nominate an organization, individual or family to be considered for a donation. When finished filling out this form, please email in an essay no shorter than 500 words why you are nominating this person/family/organization. Email essay to"

***Please be advised we support the Sioux Empire region at this time***

Your Name *
Your Phone Number
Your Email Address *
Your Address *
Check All that Apply:
Name of Person, Family or Organization being nominated:
Their Address *
Their Email Address
Their Phone Number
Best person to contact:
How to best reach contact person:
How did you hear about Rush for the Causes:

"Do NOT forget to email your essay to If you do not submit an essay within 24 hours your nomination will NOT be considered."