Please fill out this form if you know someone who could use encouragement and would like to RECEIVE a smile.

Please note that  the Recipient’s name and information will not be published on this site.  I will send emails to the “Senders” to maintain privacy.

In the Recipient’s information section, please include the following:

Name of Recipient:

Age:

Diagnosis and stage if applicable:

Address for cards to be sent:

Birthday:

Would person prefer to receive religious type cards or not?

Has this person given permission to have their information shared?  We don’t want to invade anyone’s privacy.