Belle Nomination Form - ChiGivesBack

Erica’s Belle of the Ball: Nomination Form

Erica’s Belle of the Ball gives one high school young lady a free prom send-off. ChiGivesBack provides her dress, hair, makeup, transportation, and more, honoring Erica’s mission to create a magical prom night for a deserving young lady. Know a student who deserves it? Nominate her below.

Student Contact Information

Name(Required)

First Last

Email(Required)

Phone(Required)

Country Phone Number

Social Media Handle(Required)

Instagram, TikTok, or Snapchat

Parent/Guardian Contact Information

Parent or Guardian Name

First Last

Parent of Guardian Phone

Country Phone Number

School Information

Full Name of High School(Required)

Are you currently a Senior?(Required)

Do you currently have a 2.5 GPA or higher?(Required)

What is the date of your prom?(Required)

Nomination Questions

1. Why do you deserve to be selected for Erica's Bell of the Ball Prom Send Off?(Required)

What does body positivity mean to you? How do you promote body positivity?(Required)

Please upload video response below.

File(Required)

Drop files here or

Max. file size: 1 GB.

What does your dream prom night look like?(Required)

Please upload video response below.

File(Required)

Drop files here or

Max. file size: 1 GB.