Anniversary Card Registration
If you would like to receive an annual anniversary card from Hope After Loss in remembrance of your baby on their special date(s), please fill out the information below. You can also use this form to update your information if you move.
Sign in to Google to save your progress. Learn more
First Name *
Last Name *
Email *
Mailing Address (Example: 222 HAL Road, HAL City, CT 12345) *
Name of baby or babies. If you did not name your baby, you may put in "baby girl" or "baby", "baby boy"; really any way you would like us to refer to your sweet baby(ies).   *
Special date #1 *
MM
/
DD
/
YYYY
Special date #2
MM
/
DD
/
YYYY
By checking this box, you are acknowledging that you have requested us to send cards to you in remembrance of your baby or babies. You also understand that you should email info@hopeafterloss.org if you would like to be removed from this list in the future. *
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Hope After Loss, Inc.. Report Abuse