Nikken Wellness Home Initiative Nomination
Enter the information below to nominate an individual, family or organization that you would like to see the Nikken Wellness Home Initiative support. Let us know WHY you are excited to support them. We want to hear their story in your words!
Type of Entry: Individual Family Non-Profit Organization Church Other:
Name (individual, family or organization):
Nominee Website (if applicable):
Address:
City: State/Prov: Zip/Postal Code:
Country: Telephone: Email:
Why this individual, family or organization should receive a free Nikken Wellness Home (up to 500 words):


Send confirmation to: