Life Story Book Form
Directions:
Please fill out the information below pertaining to the topics that you would like to include in your Life Story Book. Upload any photos for each corresponding section that you would like to include. ~Thank you!
Contact Information
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Name of Book Recipient (First and Last)
Address where you would like the book to be sent
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Early Years
Date of Birth
Place of Birth
Photos of Place of Birth
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Name of Parents
Photos of Parents
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Name(s) of Sibling(s)- if uploading group photos, please specify their placement in the photo you are uploading (ex: on left in green shirt, etc)
Photos of Sibling(s)
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Name of Town/City Lived Growing Up
Photos of Hometown
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Names of Schools Attended in Childhood
Photos of Schools
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Names/Breeds of Any Childhood Pets
Photos of Childhood Pets
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Adolescence/Young Adulthood
Graduation From High School (Name and Location)
Photos of Graduation/High School
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College or Work
Photos of Graduation/High School
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Marriage (Name and Date) Please include any information pertaining to how they met, where they married, etc.
Photos of Wedding
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Military Service- Please include any known dates of service, branch of military or any wartime involvement.
Military Photos
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First Home- Describe the home and include address/town.
Photos of First Home
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Children- if uploading group photos, please specify their placement in the photo you are uploading (ex: on left in green shirt, etc)
Photos of Children- You may include one younger and one current photo of each child, if you choose.
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Pets (Name and Breed)
Photos of Pets
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Special/Favorite Family Vacations
Photos of Family Vacations
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Family Cars
Photos of Family Cars
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Middle Age/ Recent Years
Current Address and How Long Lived Here
Photos of Current Home
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Grandchildren- if uploading group photos, please specify their placement in the photo you are uploading (ex: on left in green shirt, etc)
Photos of Grandchildren
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Achievements/Awards
Photos of Honoring Achievements/Awards
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Volunteer Work
Photos of Volunteer Work
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Hobbies
Photos Participating in Hobby
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Current or Most Recent Travel
Photos of Current or Most Recent Travel
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Pets
Photos of Current or Most Recent Pets
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Favorite Things
Books
Movies
Sayings
Season
T.V Shows
Songs
Types of Music
Actor/Actress
Color
Vacation Spots
Food/Drinks
Cars
Poem
Things To Do
Other
Preferences
Language Spoken
Religion
Please List any Allergies to Food, Medications, Substances, Etc.
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Morning Routine
Please be specific (for example: type of lotions, soaps, toothpaste, denture adhesive, hair care products, coffee and if they use creamer, sugar, etc., types of other beverages, dress before or after breakfast, foods preferred, wears robe, slippers, looks at the paper, watches the news, prays, etc). Include approximate time of wakening.
Morning Routine
Bedtime Routine
Please be specific (for example: wash up before bed, what type of bedclothes, fluffy or flat pillow, many or few blankets, keep music/lights on, have a glass of water nearby, watch t.v., pray, etc.) Include approximate time of going to bed
Bedtime Routine
Food Likes/Dislikes
Type a question
Like
Dislike
Meats
Fruits/Vegetables
Dairy Products
Sweets
Starches
Drinks
Seafood
Other
Other
Please use this section if there is anything else you would like added to your book.
Other Information
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