Back Home Next

Order form

Print this form out. Fill out legibly, type or handwritten neatly, and mail with photographs. Fill out whatever information you want to, if needed add another sheet of paper.  On the back side of your photos or a piece of paper accompanying them, write down who is in the photo and the year the photo was taken.  All information is confidential and will not be used or sold to any other parties whatsoever for any purposes.

                                                            

Memories in a Nutshell

Write a brief autobiography. Add a page/s. You can use the questions below as a guide or just fill out questionnaire.

Name_______________________________________________________________

Date of birth_______________ Location___________________________________________

Schools prior______________________Year_____ Location _________________________

High School_______________________Year_____ Location ___________________________

College/s_________________________Year_____Location_____________________

Employment_______________________Year_____Location____________________

_____________________________________________________________________

_____________________________________________________________________

Degrees_____________________________Location__________________________

Achievements/Awards___________________________________________________

Military Service______________________________________________________________

Cities of Residence___________________________________________________________

Marriage/s-date and spouse's name_______________________________________________

Children-birthdates and names_____________________________________________________________

__________________________________________________________________

Grand Children-birthdates and names_____________________________________________________________

__________________________________________________________________

Great-Grand Children-birthdates and names_____________________________________________________________

__________________________________________________________________

Pets-breed and names__________________________________________________________

Travels-years and places visited_____________________________________________________________

__________________________________________________________________

Special talents and abilities____________________________________________________________

Other pertinent information:________________________________________________________

__________________________________________________________________

__________________________________________________________________

Favorite book_____________________________________________________________

Favorite movie____________________________________________________________

Favorite saying____________________________________________________________

Favorite food_____________________________________________________________

Favorite song lyrics____________________________________________________________

Favorite city and memory of it____________________________________________________

Favorite moment/s or memory___________________________________________________

Favorite quote or expression____________________________________________________

High point in your life__________________________________________________________

Low point in your life__________________________________________________________

Bravest moment___________________________________________________________

Biggest Fear Overcame_________________________________________________________

Biggest regret_____________________________________________________________

 

submitted by____________________________

e-mail address_____________________________

address to send book to_______________________________________________

 

 

Print this form out, fill out and email me and I will send you my address so you can send me your photos and completed order form with return address and with payment of $125.00 for up to 6 color photo composite pages and $20 per page additional. For additional copies the charge is $35.00 per book.  All data will be kept on disks for future use. Include school names, jobs, military service, pets, etc. A page can consist of up to approximately 10 photos or more, according to how big or small I make them. So, find whatever photos as you wish to represent your life.  E-mail photos and specify names and dates and address to send the book to. If you can't e-mail photos or don't have a scanner, you can mail me your photos and I will mail them right back to you. The book is spiral bound, with laminated sheets.  val@valscreativedesigns.com
val@valscreativedesigns.com
Copyright © 2003 - 2013  [www.memoriesinanutshell.com]. All rights reserved.
Revised: 08/03/13