Mother's Day Tribute Form

Mother’s Name:*
First Last
Mother’s Town of Residence:*
Children’s Names:*
What do you love most about your mom? What makes her so special?*
What is one favorite memory of your mom?
Photo Upload*
Accepted file types: jpg, Max. file size: 2 MB.

Please submit a high-resolution image under 10 MB in JPG format.
Consent*
I agree to the terms stated below:
When you submit a photo to EPC, you agree and represent that you created the photo, or you have received permission from the owner to submit the photo to EPC and to license the photo as stated below.

By submitting a photo to EPC, you are granting EPC an unconditional, irrevocable, non-exclusive, royalty-free, fully transferable, perpetual worldwide license to use, publish or transmit, or to authorize third-parties to use, publish or transmit your photo in any format and on any platform, either now known or hereinafter invented.
Contact Information
Email address and phone number will not be published in print.
Submitter’s Name:*
First Last
Contact Phone*
Contact Email*
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Contact Information