Gracie's Gowns Butterfly Bead Sign-Up
Since the start of Gracie's Gowns in 2012, we have worked with other organizations on many different levels and have learned more about programs that are available to children with chronic and life-threatening illnesses. One of those programs has included the various arts in medicine organizations that have bead programs.

Many of our families participate in such programs, and we would love to present you with a special bead that represents our organization to be included on your strands. A bead that not only says you've received a gown from our organization, but that you are a part of our family here at Gracie's Gowns.

We have a special, handmade lampwork butterfly bead that can come in various colors, but is a bead our organization will be giving out to those that participate in one of the programs and would like to add it to their story. It will not be included in your program's journal/log and we are not endorsed by any of these programs (meaning they aren't offering it to you, but Gracie's Gowns is), it would be a special bead you can share the story of with others.

Each bead will have an expense of about $15.00 to cover the time and supplies of the artist and shipping to Gracie's Gowns, as well as, to each child. We will order them in groups of about 50 and will be looking for donations/sponsors specific to this program. The turn around time may take 4-6 weeks once they are ordered, as each bead is handmade and has to be carefully packaged and shipped.

We are not asking for payment from any of our families, but should you like to cover part or all of the expense for your child, we will set the funds aside specifically for their bead until we can place a full order.

Child's First and Last Name Receiving our Bead *
Your answer
What Bead Program Does Your Child Participate In? *
Have You Requested/Received a Gown from Gracie's Gowns? *
What is the child's mailing address? *
Your answer
Color Preference of Butterfly Bead *
Based on Availability
Are you able/willing to help towards the costs of their bead? *
Each bead is roughly $15.00 with material cost, and shipping to two locations.
Parent/Guardian's First and Last Name *
Your answer
Parent/Guardian's Contact E-mail *
Your answer
Never submit passwords through Google Forms.
This form was created inside of Gracie's Gowns. Report Abuse - Terms of Service