Memory Card Request
To create your cards, we will need the following information:
Your Relationship to Donor
City, State and Zip code
Donor's Legal Name
Name as you would like it to appear on the card
Date of Birth
Date of Death
please let us know if you want to see a proof before printing, want a copy of the PDF to print additional cards on your own, have a deadline, etc.
Poem and Photo
Which poem would you like to appear on the back of the card?
A Hopi Prayer
We Remember Them
Other - please copy & paste below
Words of Tribute
There is a 700 character limit for submitted poem
Upload an original photo file of your loved one - We recommend a rectangular, portrait style photo (like the image to the right).
Please do not send a picture of a photo, it may not print clearly
If you have questions or concerns, please email us:
reCAPTCHA helps prevent automated form spam.
The submit button will be disabled until you complete the CAPTCHA.