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Life Interrupted Foundation's
Legacy of Love Nomination Form

Legacy of Love Scholarships are granted at the end of each quarter. A child is eligible to receive up to $2,500 to support a 529 account, IRA account or sponsorship to a bereavement camp.

Your first name

Your last name

Your personal email

Your personal phone number

Name of loved one, relationship to nominee, any information you'd like us to know

Date of Passing
Month
Day
Year

What makes this child remarkable? How do you think this scholarship could benefit this child's future?

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