Request a FREE Certificate of Life!
To honor your Angel Baby's life, we would like to send you a free Certificate of Life! Please fill out this form with all information you would like to be included on the certificate. If any information is unknown, simply type "N/A." Please fill out a separate form for each baby, if more than one.
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Your name *
Your e-mail address *
Parent name(s) *
Baby's name (as you would like it to appear on the certificate) *
Baby's gender *
Date of birth  (if known)
Place of birth (name of hospital or location, if known)
Weight (if known)
Length (if known)
We would love to hear from you! Please check the Support & Resources Section and share your hearts on the posted discussions, quotes, and poems. We belong in this loving community. Let's spread the awareness on pregnancy and infant loss. Follow us on Facebook: Anjela's Box and Instagram: @AnjelaBox. Are you in? *
Any questions or comments?
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