Life Story Book Form — Show Me the Way

Directions:

Please fill out the information below pertaining to the topics that you would like to include in your Life Story Book. After clicking the 'Submit' button, you'll be redirected to a page where you can upload the corresponding photos for each section you'd like to include. ~Thank you!

Name

First Name

Last Name

Phone

(###)

###

####

Name of Book Recipient

Shipping Address

Please enter the mailing address where you'd like the book to be sent.

Date of Birth

Place of Birth

Name of Parents

Name of Siblings

Name of City/Town Where They Grew Up

Schools Attended

Pets (Name and Breed)

Graduation From High School (Name and Location)

College or Work

Mariage (Name and Date)

Please include any information pertaining to how they met, where they married, etc.

Military Service

Please include any known dates of service, branch of military or any wartime involvement.

First Home

Children

Pets

Special Family Vacations

Family Cars

Current Address and How Long

Grandchildren

Achievement or Awards

Volunteer Work

Hobbies

Travel

Pets (Name and Breed)

Books-

Movies-

Sayings-

Season-

T.V. Shows-

Songs-

Types of Music-

Actor/Actress-

Color-

Vacation Spots-

Food/Drinks-

Cars-

Poem-

Things To Do-

Other-

Languages Spoken

Religion

Please List Any Allergies To Food, Medication, Substances, Etc.

Morning Routine

Please be specific (for example: type of lotions, soaps, toothpaste, denture adhesive, hair care products, coffee and if they use creamer, sugar, etc., types of other beverages, dress before or after breakfast, foods preferred, wears robe, slippers, looks at the paper, watches the news, prays, etc). Include approximate time of wakening.

Bedtime Routine

Please be specific (for example: wash up before bed, what type of bedclothes, fluffy or flat pillow, many or few blankets, keep music/lights on, have a glass of water nearby, watch t.v., pray, etc.) Include approximate time of going to bed.

Meats You Like:

Meats You Dislike:

Fruits/Vegetables You Like:

Fruits/Vegetables You Dislike:

Dairy Products You Like:

Dairy Products You Dislike:

Sweets You Like:

Sweets You Dislike:

Starches You Like:

Starches You Dislike:

Drink You Like:

Drink You Dislike:

Other

Please use this area for any other information you would like to add to the book.