Share the Warmth Initiative Nomination Form

At Ember Ridge Firewood, we believe warmth should never be out of reach. Through our Share the Warmth Initiative, we provide firewood assistance to local families experiencing financial hardship, unexpected circumstances, health challenges, or other situations that make heating their home difficult. If you know someone who could benefit from this program, please complete the nomination form below.

Nominator Information

Your name

Your phone number

Your email address

Nominee Information

Nominee full name

Nominee phone number

Nominee email address

Nominee address

Country/Region

Address

City

Zip / Postal code

Household Information

Number of adults in household

Number of children in household

Does the household currently use firewood as a primary or supplemental heat source?

Primary Heat Source

Supplemental Heat Source

Both

Unsure

Nomination Details

Please tell us why you are nominating this individual or family

How would receiving firewood help this household?

Supporting Information

Upload supporting documents (optional)

Upload your file

Choose a file or drag and drop one here.

Upload photo (optional)

Upload your file

Choose a file or drag and drop one here.

Consent

I understand that submitting this nomination does not guarantee assistance. Ember Ridge Firewood reserves the right to review nominations and distribute assistance based on available funding, firewood inventory, and program guidelines.

I certify that the information provided is true and accurate to the best of my knowledge.

Share the Warmth Initiative Nomination Form

Nominator Information

Your name

Your phone number

Nominee phone number

Nominee email address

Nominee address

Country/Region

Address

City

Zip / Postal code

Household Information

Number of adults in household

Number of children in household

Does the household currently use firewood as a primary or supplemental heat source?

Primary Heat Source

Supplemental Heat Source

Both

Unsure

Please tell us why you are nominating this individual or family

How would receiving firewood help this household?

Supporting Information

Upload supporting documents (optional)

Upload your file

Choose a file or drag and drop one here.

Upload photo (optional)

Upload your file

Choose a file or drag and drop one here.

I certify that the information provided is true and accurate to the best of my knowledge.