Rizpah Network Portrait Program

The Art of Remembrance

Portraits of Healing In Honor of Homicide Victims/ Lost Loved Ones
Loved One First Name*
Last Name*
Middle Name or Nickname
Date of Birth

MonthDayYear
Date
Date of Death*
Age at Death*
Cause of Death*
City/State of Death*
Please Share your Best Memories of your loved one, or what you want others to know about who they were.*
Relationship to Honoree*
Phone Number*

Area CodePhone Number
Contact Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Submitting Photos

Photos with the following characteristics work best; An original photo (rather than a copy) to ensure the greatest clarity, A photo that clearly shows the person’s facial features, & The person is well lit. We suggest submitting at least two pictures to artist.
Upload Best Picture Here*

Upload a File

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Upload Additional Pictures Here

Browse Files

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Release

By signing name and clicking submit, I hereby authorize Rizpah Network, Rizpah partnership agencies and the Artist to use the story, image and completed portrait in a brochure, publication, photo board, billboard, media campaign, radio or television interviews or other promotion in order to raise awareness of violence. All images and rights relating to them, including copyright and claims of ownership in the media, remain the sole and exclusive property of the Artist with a limited, non-exclusive license to Rizpah. The Artist and Rizpah also reserve the right to use the story, image and completed portrait for reproduction, public display, and dissemination for the purpose of promoting Artist and/or Rizpah Network programs.
Requestor Sign Full Name Here *
I hereby given my consent to Rizpah Network
YOU CAN MAKE A DIFFERENCE

Portraits are free to families, who have lost loved ones to violence, but we do ask you to consider making a donation to help further the activities, programs & exhibits that memoralize our loved ones while raising awareness, that there lives mattered.

Donation-

USDIn Memory of Loved One

Credit Card

Should be Empty:

The Art of Remembrance

Submitting Photos

Release

Credit Card