Saint Mary's Home of Erie, PA

2019 Ageless Remarkable Erieite Nomination Form

Deadline for Nominations is April 5, 2019

Nominator's Information

Your information as the person submitting the nomination.


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.


Nominee is Currently Active with the Following Companies and/or Organizations

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

Why Your Nominee?

Please share a brief statement as to why your nominee deserves the Ageless Remarkable Erieite Award.