2017 NOMINATION FORM
BREAST CANCER AWARENESS CHARITY DRIVE
Name:
Age:
Email:
Phone number: Home address:
Nominated by: Email:
Phone Number:
What type of cancer did/do you have? When did you contract this disease?
What stage are you at: Just diagnosed? In Treatment? In Remission? Cancer free?
In your own words..what is your story as a women dealing with this disease? How has it changed you?
What is some advice you would like to share with other women dealing with this?
Are you open with sharing your story on social media so that it can help others?
Our sessions are all about empowering and uplifting women through boudoir photography, are you open to allowing yourself to be vulnerable?