Please complete the form, then click the 'Submit' button.

Name of Nominees: 
Nominees Address:   
Nominees City/State/Zip: 
Phone/Fax:       Email address: 
Number of years married:      Number of children:
Names and ages of children:
   1.      2.      3. 
   4.      5.      6. 

Nominated by:  (your name)
Your address:    City/State/Zip 
Phone:      Email address: 
Relationship to Nominees: 

Please respond to each of the following in a complete but concise way:
1. Write a brief introduction providing basic information about the nominated parents and their family.
2.  Share examples of integrity, compassion, commitment, or sacrificial devotion that the nominees embody as parents.
3.  Explain how the nominees are involved in their community or in what way they have influenced the lives of children.
4.  How are these parents strengthened by their faith, or how have they set a moral example for young people?
5.  What makes this couple shine above the ordinary?  Or what struggles have they overcome in their role as parents?

The National Parents' Day Council office may contact you for additional information, including a digital photo of the nominated parents, and other supportive materials.