NationalQuiltProject.org

Quilt Block - Story Form.

Thank you for sharing this information. Please remember the information, story and memories you share will be on a quilt that will be available for thousands of people to see. By filling out this form you are giving us permission to reprint this story for the sake of memorializing your loved one. Additionally, photos of the blocks will appear on this web site and may be shared in print or online media. You may also print this form and fill in by hand. When finished please return it to National Quilt Project c/o Laura Torrenzano, 212 Gamache Drive, Ludlow, MA 01056
Your name *

First Name Middle Name Last Name
Phone Number- This is not a required field but please feel free to share if you would like us to contact you directly.

Area Code Phone Number
E-mail. Thank you for sharing your email with us in case we have any questions. Your privacy is of utmost importance to us. We will NEVER share this information with anyone. *
Name of Fallen Serviceman/Servicewoman *

First Name Middle Name Last Name
Rank of Fallen
Military Affiliation
Date of Death
Place of Death
Name of Hometown in Massachusetts.

Your address: Your address will be strictly for verification purposes and to send you information about the quilts when they are completed. No one from our organization will contact you about this project without your permission *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

You may choose to UPLOAD a story or message that you would like printed on the back of your block. Please note, your message will be handwritten for you onto the back of the block. The area for writing is approx. 7" x 7". (the block are can hold more than 250 words but it may look a bit crowded if you go much more than that)
Feel free to type your story here instead of uploading a file. There is a 500 character limit on this field. If you think your story is very large you may email it directly to info@nationalquiltproject.org. Please put the name of the fallen in the subject line.. You may write anything you want. Need ideas? Hobbies, things they liked to do, books they loved, favorite quote, what their best friend would say about them, family members they left behind, career or school information, information published in their obituary
Do you want to share a photo? Photos may or may not be used in the quilt but may be used at a later date for written publications about the quilt.
Calculation
Please feel free to share any other information you may find relevant.
Enter the message as it's shown *
Number
Click to edit

Month Day Year
at
Hour Minutes AM/PM Option
Should be Empty:

Quilt Block - Story Form.