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Sibling Superstars
Please answer the following questions as best you can.
Tell us about your
Bravo Brother
:
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Indicates required field
What is the name of the CRMO child nominating his/her brother)?
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First
Last
What is the nominated brother's name?
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First
Last
What is his DOB?
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What makes your Brother Bravo?
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Does your brother collect anything? Have any hobbies? What does he like to do in his spare time? Does he have favorite TV/movie characters, superheroes or others?
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Is there anything that especially makes your brother happy? If yes, what?
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What are your brother's favorite candy, snacks, treats?
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What are your brother's favorite colors?
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Please provide your brother's mailing address:
Name
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First
Last
Address
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Line 1
Line 2
City
State
Zip Code
Country
Name of person filling out this form or certifying that this information is true and accurate (must be 18 or over):
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First
Last
Are you the parent, caregiver, other (please explain if other):
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Email address of person over 18 years of age:
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DOB:
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Please check the box below to confirm that you are 18 years or older, that you attest that this care package is being requested for a sibling of someone with CRMO, and that you authorize Kaila's Komfort to use your testimonial and/or photos on our website, Kaila's Komfort Facebook page, and any promotional materials. If you have any stipulations on the use of your story/photos, please note them in the Comment box below.
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Yes
Comments
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Please note that we are only able to send one sibling care package per person as we are a tiny non-profit that runs 100% off of donations.
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