Dinner for Two

Nominate a Couple Today

Dinner for Two

Do you know a first responder who would benefit from a date night?

Use the form below to nominate a first responder today:

Your First Name

Your Last Name

Your Email Address

Your Phone Number

Recipient First Name

Recipient Last Name

Recipient Address

Recipient Agency

Your Message

Nomination Agreement

Our recipients regularly inquire who nominated them. This is always fun and exciting to share. May we please share that you nominated them for this special date night?