Treasured Memories Program
Hello There!
We need to collect some information from you for our selection process. Please understand while we would love to be able to offer this to every single nominee, it just isn't possible.
Nominee's First Name
Nominee's Last Name
Age of Nominee
Details on why you think they should be gifted the session.
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Illness details
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Prognosis of Nominee
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Your relationship/How do you know the nominee?
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Please attach a recent photo of the nominee
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Your Name
Your Phone Number
Your Email
Any other details you would like to provide to help us narrow down the selection process?
Message
if the nominee is not selected or does not meet the criteria for the free session but would possibly be eligible for a discounted session would you be interested in making a donation towards their session to keep the cost down for the family.
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Yes
Not at this time
Maybe
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