Please enter the child’s first name (or nickname) who will own and read this book:

• Please enter the name of the lost loved one:
  

• Choose ONE thing your child and the departed did often together:

Snuggling
Playing
Hugging
Camping
Running
Other

• Choose TWO things your child gave the departed:

Hugs
Treats
Kisses
Love
Other
Other

• Please choose a spiritual hope you would like to promote with the child:

Heaven
A magical place
A fun place
A beautiful place
Other

• Please list two other loved ones (animals and/or persons) the child has lost:

• Shipping information:

Name:     

Address: 

City:       

State:        Zip: 

Phone:     

Shipping and Handling charges (within U.S.):