JennaJackPack Request Form

Please share the following information with us, so that we may customize the child’s JennaJackPack (JJP) as best we can. Note: JJP’s are customized for children ages 3-13.

Child’s First Name

Choose one option

Boy

Girl

Child’s Age

Relationship of the family member that passed to the child

Brother

Sister

Mom

Dad

Favorite Color

Favorite Candy/Snacks

Favorite Hobbies / Interests / Activities

Requestor’s Name

Requestor’s Email

Requestor’s Phone Number

How did you hear about us?

Name of school/business/group/person we should thank for sharing our message

Additional information for us to consider