2008 SOFT Annual Video Presentation

Picture Submission

Each year SOFT assembles photographs of our wonderful children in order to produce a video, that celebrates their lives.
We invite you to submit a few of your or a special child's photos to be a part of this year's video.

Please provide the following parent or guardian contact information: *Required Fields

First Name*

Last Name*

E-mail*

Street Address

Address (cont.)

City

State/Province

Zip/Postal Code

Country

Phone

Web Address

Please identify and describe the Child whose photograph you are submitting:

Child's First Name*

Child's Last Name*

Child's Middle Name

Child's Date of Birth

Child's Death Date

Child's Gender Male Female

Please identify the Child's condition:

If answered "Other Related Disorder" above, please specify here:

Please submit your pictures here*:
(You can submit up to 3 images, but you must submit at least 1)

->Please note that the pictures must be in .gif, .tiff, .jpg, .jpeg, or .png format and be under 1.25 MB

Any other information about the child or the pictures?

For children who are deceased, would you like these pictures saved and used in future videos?

Yes No

Would you like to authorize this picture for use in other SOFT publications?

Yes No

For estimation purposes, if you are not attending conference, are you planning on purchasing a this year's SOFT video (no obligation)?

Yes No

Are you planning on attending this year's conference?

Yes No Undecided

First Name*
Last Name*
E-mail*
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Phone
Web Address

Child's First Name*
Child's Last Name*
Child's Middle Name
Child's Date of Birth
Child's Death Date
Child's Gender	Male Female

2008 SOFT Annual Video Presentation

Picture Submission

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