One moment please...
Cornerstone of Hope Pregnancy & Infant Loss Service
Saturday, October 15, 2022 at 6:30 p.m.
Number of Candles
*
Quantity
$20
-
Per Candle
0
1
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8
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10
10
Contact Information
Name
*
First Name
Last Name
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Phone
*
Email
*
Infant Information
Gender:
select one
Boy
Girl
Did not know
Date of Birth:
(mm/dd/yyyy)
Date of Death:
(mm/dd/yyyy)
Name to be Read During Service:
*
First Name
Last Name
Phonetic Spelling of Name:
2 or 3 sentences about your child to be read as you walk down the aisle to light your candle:
This is optional. Longer sentences will be edited due to time constraints.
Photo Preference for Display on Candle:
*
select one
Use my photo from last year
Upload a photo now
Do not have a photo, please use a photo of an angel
Upload Photo for Display on Candle:
*Optional
Number of Guests Attending:
select one
1
2
3
4
5
6
7
8
9
10
Contact & Payment Preferences
Contact Preferences
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