Request Support from The Memory Mailbox
The Memory Mailbox provides free curated greeting card bundles and comfort care packages to individuals facing terminal illness, as well as their immediate families and caregivers. Please complete this form so we can better understand how we can support you or your loved one.
Who is submitting this request?
*
Individual facing terminal illness
Family member
Caregiver
Other
Your Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Name of the Individual We Are Supporting
*
First Name
Last Name
What is their age group?
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Child
Teen
Adult
Senior
Who would they like to prepare cards for?
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Spouse or Partner
Child/Children
Grandchild/Grandchildren
Parent(s)
Sibling(s)
Other Family Members
Friend(s)
Other
What kinds of cards are needed?
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Birthday
Christmas/Holiday
Graduation
Wedding
Anniversary
Mother's Day
Father's Day
Valentine's Day
Other Holidays
Future Milestones
Just Because
Blank/General
Other
Please tell us a little about who the cards are for.
*
Example: 3 grandchildren, ages 5, 10, and 16; daughter graduating high school next year.
What style of cards would you prefer?
Heartwarming/Sentimental
Funny/Lighthearted
Inspirational
Religious/Faith-Based
Non-Religious
Simple
Colorful/Fun
A Variety
No Preference
Other
Is there anything you would prefer we NOT include in the card bundle?
For example: religious messages, adult humor, certain holidays, themes, or card styles.
How would you like to receive your card bundle?
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Hand Delivery
Shipping
Delivery/Shipping Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How soon is the card bundle needed?
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As soon as possible
Within 1 week
Within 2 weeks
No immediate time concern
Is there a specific date we should be aware of?
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Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Please include any upcoming milestone, special occasion, or other important date we should keep in mind.
How did you hear about The Memory Mailbox?
Family or Friend
Hospice or Palliative Care Provider
Healthcare Provider
Cancer Support Organization
Social Media
Community Event
Internet Search
Other
Please confirm:
*
I understand that card selections are based on available donated inventory and that specific designs, brands, quantities, or occasions cannot be guaranteed.
Is there anything else you would like us to know?
Please share any additional information that may help us prepare your card bundle.
Submit My Request
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