Fox 13 Dream Team Nomination Form

What would make a difference in the life of someone you know?
Tell us their story as it would be told on TV.

Your Information
* Your First Name: 
* Your Last Name: 
* Your Email Address: 
* Your Phone #: 
* Your ZIP Code: 
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Nominee's Information
* Nominee's Name: 
* Please explain in detail why this person deserves a visit from the FOX 13 Dream Team.: 
  Words Remaining:

Please share their story as it might be told on television and keep your answer to 500 words or fewer.

* Nominee's Address Line 1: 
* Upload Photo: 
  Please upload a JPEG file (.jpg or .jpeg)
Nominee's Address Line 2: 
* Nominee's Phone #: 
* Nominee's City: 
* Nominee's Zip Code: 
* Best Time to Surprise Nominee: 
* Suggest a Surprise for Nominee: 
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Dream Team Nomination Form

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