Legacies Live On Inc. Care Package Form
Care package form
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Email *
Your First Name *
Your Last Name *
Your Phone Number
Care Package Recipient First Name *
Care Package Recipient Last Name *
Care Package Recipient Email *
Care Package Recipient Mailing Address *
Recipient's Loss *
If you clicked "other" in the previous response, please indicate who the loss was.
If you feel comfortable, please share brief details on the care package recipient's loss. Additional context helps with customizing the package to cater to the recipient's needs as much as possible, but it is not required.
Recipient's Favorite Things (e.g., snacks, self-care, activity, sports team, writing, etc.) *
Recipient's Favorite Colors (put n/a if unsure)
Select a donation package *
For individual package, please select t-shirt size(s)
For family, provide T-shirt sizes (up to three sizes only)
Donations help us fulfill our mission to support young grievers in honoring their loved one's legacy with purpose. In addition to the care package, would you also like to donate and help our cause?   *
Donation Amount ($USD) (Please click the link on the next page to complete payment)
Do you require a tax receipt?
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