Lovie Application - Fort Leonard Wood ASYMCA

Step 1 of 2

Applicant's Name*

First Last

Email*

Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Military Sponsor's Name*

First Last

Sponsor's Military Rank*

Who is the Lovie for?*

Child's Name

Child's age*

Their age is in:*

Months

Years

What is your qualifying event?*

First Deployment

Deployment is longer than any prior deployments

Struggling with recent big move

Separation anxiety due to regular, frequent absense of parent

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How do deployments affect you and your family?*

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Will this be your child's first experience with deployment?*

Yes

Tell us a little bit about this upcoming or ongoing deployment and how it's affecting you and your family.*

Please keep OPSEC in mind with your response (You can talk more about your nervousness/anxiousness, things you're doing to prepare, how it affects your child(ren)...etc)

Tell us a how more about how military life is affecting you and your family.*

Please keep OPSEC in mind with your response. You can talk about the aspects of military life that challenge you, the emotional impact, and how it all affects you and your family.

Please tell us your child's preferred Lovie

Note: We will do our best to accommodate every child's first choice, but due to inventory may need to send their next choice. In the next question, you will specify which is your child's first choice

Additonal Children

You can order additional Lovies at a discount for other eligible children in your home. The discount is currently 35% off of $35, but prices and discount rate may be subject to change. If you select yes to this option, you will receive a discount code directly from Little Bug and a link to place your order for the child(ren) listed below.

Are you interested in receiving a Lovie for other children in your home at a discounted cost?*

Yes

	First Choice	Second Choice	Third Choice
Bear
Lion
Sloth

Request a Lovie

Important Notes:

Additonal Children

Who is the "Little Bug" for?	Actions

There are no Children.