Saint Mary's Home of Erie, PA

Ageless Remarkable Erieite Nomination Form

Deadline for Nominations is April 10, 2020

Contact Emma Toner at 814-451-1316 or etoner@stmaryshome.org with questions.

Nominator's Information

Your information as the person submitting the nomination.

xxx-xxx-xxxx

Nominee's Information

About the individual or couple you are nominating.

If nominating a couple, list both first names here.

If nominating a couple, both must be age 75 or older.

xxx-xxx-xxxx

Nominee's Involvement

Please identify the name, contact person, and phone number for each organization that you list. You must list at least one.

Statement of Support

Please share a brief statement as to why your nominee is an Ageless Remarkable Erieite.