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Your Information
First Name
Last Name
Email
How did you find We Choose Happy?
Address
Apartment, suite, etc.
City
State
Zip/Postal Code
Recipient Information
Recipient First & Last Name
Recipient Age
What is the recipient's disability and/or medical condition?
Has the recipient ever recieved a "wish" from a different organization?
Yes
No
Is the recipient currently living with the disability or medical condition?
Yes
No, the recipient has recovered from the disability or medical condition
Does the recipient and/or family know you are nominating them?
Yes
No
Please tell us the story of why you are nominating this recipient?
What in your opinion would make this recipient the happiest?
Is there a specific "happy" you are requesting for this recipient?
Recipient's Favorite Color
Recipient's Favorite City
Recipient's Favorite Sports Team
Recipient's Favorite Celebrity
Recipient's Favorite Things To Do
Please add any additional information here.
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