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Create a Memorial
Honor your loved one by sharing their story
Please tell us about your loved one.
First Name
Middle Name
(optional)
Middle Name
Last Name
Date of Birth
Date of Birth
Date
Date of Death
Date of Death
Date
Please describe your loved one in 5 words or less.
(Example: “Brother, Father, Heart of Gold”)
What words best describe your loved one? (enter 3-5)
Tell us a little about your loved one through your eyes.
(optional)
Tell us a little about your loved one through your eyes. (optional)
About text formats
Plain text
No HTML tags allowed.
Lines and paragraphs break automatically.
Web page addresses and email addresses turn into links automatically.
250
characters
What is your favorite memory of them?
(optional)
What is your favorite memory of them? (optional)
About text formats
Plain text
No HTML tags allowed.
Lines and paragraphs break automatically.
Web page addresses and email addresses turn into links automatically.
500
characters
What will you miss most about them?
(optional)
What will you miss most about them? (optional)
About text formats
Plain text
No HTML tags allowed.
Lines and paragraphs break automatically.
Web page addresses and email addresses turn into links automatically.
500
characters
How would they like to be remembered?
(optional)
How would they like to be remembered? (optional)
About text formats
Plain text
No HTML tags allowed.
Lines and paragraphs break automatically.
Web page addresses and email addresses turn into links automatically.
500
characters
Please upload a picture of your loved one.
(optional)
Choose an image that is at least 400 pixels tall by 400 pixels wide and between 20KB and 8MB.
You can drag and resize the square to select how much of the image will appear in the memorial. Your selection will be automatically saved.
Select a file
Please upload a picture of your loved one.
One file only.
8 MB limit.
Allowed types: png gif jpg jpeg.
Images must be larger than
400x400
pixels.
Include a link to your loved one’s Facebook page
(optional)
Include a link to your loved one’s Facebook page (optional)
This must be an external URL such as
http://example.com
.
Include a link to your loved one’s obituary
(optional)
Include a link to your loved one’s obituary (optional)
This must be an external URL such as
http://example.com
.
Would you like to allow people to donate in honor of your loved one?
No
Yes
Gifts will support Shatterproof’s work to reverse the addiction crisis and save lives.
Please tell us about yourself
If you’re creating this memorial with someone else, please choose one primary contact.
Your First Name
Your Last Name
Your Email
Please keep me informed about Shatterproof’s important work.
We will ONLY email you about your memorial unless you ask us to keep you informed about our work (below).