AVMCC Nominate Form

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ACTIV8HER LIVE 2026: Activ8Her Joy!

Nominate a Single Mom

Your First Name

Your Last Name

Your Email

Your Phone

Activ8Her Chapter You Attend

Name of Single Mom:

Nominee's Email

What Size T-Shirt Does Mom Wear?

I agree and acknowledge that I am responsible to deliver the gift to my nominee before Christmas day.

Thanks for submitting!

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