Luminary Kit Request Form for Candlelight Vigil
Please enter your information below to request a kit to be mailed to you. It will contain markers, a white luminary to personalize in honor of your loved one, and a stamped envelope to return to NCVAN. You will need to send the personalized luminary in the enclosed envelope dated by November 30, 2025. Our candlelight vigil is December 11, 2025. We will also have materials to create a luminary at our vigil. Please contact elizabeth@nc-van.org if you have questions.
Your Name
*
First Name
Last Name
Name of Your Loved One
*
First Name
Last Name
Phone Number
E-mail
*
example@example.com
Mailing Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please respond below.
*
Yes, I would like to be added to NCVAN's email list
No, I would not like to be added to NCVAN's email list
Submit
Should be Empty: