NOMINEE INFORMATION

Nominee's First Name*

Nominee's Last Name*

Nominee's Address*

Nominee's Email

Nominee's Phone Number*

Relationship to Nominee*

Is the nominee aware they are being nominated?*

Yes

No

How did you hear about Neighbors First Initiative?*

Which best describes the nominee?*

Senior Citizen

Low-Income Individual/Family

Disabled Individual

Veteran

Other

Is the nominee currently struggling to maintain their property?*

Yes

No

Has the nominee received similar assistance recently?*

Yes

No

Not sure

What services are needed? (Select all that apply)*

Junk / Debris Removal

Yard Waste Removal

Pressure Cleaning

Other

Briefly describe the condition of the property.*

How long has the property been in this condition?*

1-2 Year(s)

3-4 Years

5+ Years

What challenges are preventing them from maintaining their property?*

Tell us their story*

Upload Recent Photo(s)/Video of Property*

Are you willing to be contacted for follow up questions?*

Yes

No

Anything else we should know? Optional

Disclaimer

Submitting a nomination does not guarantee selection. All nominees are subject to review and verification based on need, eligibility, and available resources. Every story matters, and we keep strong candidates in consideration for future projects.

CompleteCare Property Solutions

Your Property, Our Priority.

954-247-1268 | info@completecarepropertysolutions.com | 6295 W Sample Road Unit 670784,Coral Springs, FL 33067

Privacy Policy

Accessibility Statement

Terms & Conditions

Refund Policy

bottom of page