Acts of Kindness Nomination Form

We will do our best to deliver gifts for all submissions. Nominees living in leesburg (or close by in Loudoun County, VA) are easiest for us to fufill so they may be completed sooner then others.

First, give us your information. We may reach out for more information.

Your name

Your phone number

Your email address

Who are you nominating for an Act of Kindness?

Name of person you are nominating

Address of person you are nominating

Why are you nominating this person?

Is there a best day or time to deliver the gift so perishables are not sitting out all day on a front porch?

Select the type of gifts that they would enjoy

Coffee drinker

Tea drinker

Flowers

Pastries

Somthing Cozy

Somthing healthy

Toys/books for kids/baby

What else can you share that will help us select the perfect gift?

Acts of Kindness Nomination Form

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