Nominate a Loved One Experiencing Loss
On the 28th of February we will be taking flowers, a hand written note and a photo to your dear family/friend. We are excited to hear the favorite memories and wonderful things about who they are. We would love for you to nominate someone so we can encourage, pray, and lovingly celebrate the life of the one they’ve lost. Nominations due by Feb 20.
Nominee's Full Name
*
First Name
Last Name
Nominee's Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Nominee's Email Address (if known)
example@example.com
Address of where we can deliver the flowers and card.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please share the Name of the loved one they lost. As well as some information you would like us to know about the loved one.
Your Name
*
First Name
Last Name
Your Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Your Email Address
*
example@example.com
Photo upload (optional)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit Nomination
Should be Empty: