Chemo Cap Submission Form

A completed copy of this form should accompany every cap you submit to Head Huggers. It will provide us with the information we need to have before we can distribute the cap you have made.


Who made this cap?

   Name    ___________________________________________

   Address ___________________________________________

   City    ___________________________  

   State   _______    ZIP ____________

   Phone   (______) ______ - _________

   Email   __________________________________________

Does the fiber contain any wool?
Yes _____ No _____ Unknown _____

Yarn (or fiber) content: If the fiber content is unknown, please write ‘unknown’ in the space below.

Send this form along with the cap to:

With Love From Sherri
c/o Catherine Minor Worley
1021 Forest Lodge Lane
Charlottesville, VA. 22903

Please include a 15″ piece of the yarn used for a knit or crocheted cap. The small added piece of yarn will be used to affix the label to your cap.

Thanks very much for your contribution, and we look forward to hearing from you again!