Story-driven keepsakes created with care

Retirement Story Questionnaire

Honor a dedicated career, the lives touched along the way, and the lasting legacy being celebrated.

Section 1 — The Retiree

Tell us about the retiree and the milestone being honored.

Retiree Full NameFull legal or given name

Preferred Name or Nickname(Optional)Name used among colleagues and family

Organization, Employer, or Service Branch(Optional)e.g., General Electric, St. Jude Hospital, US Navy, Self-Employed

Role, Title, or Professione.g., Senior Vice President, 5th Grade Teacher, Master Carpenter

Department, Field, or Trade(Optional)e.g., Pediatric Oncology, Civil Engineering, High School Science

Total Years of Service / Career Spane.g., 34 Years (1992 – 2026)

The story of how their career started, evolved, and achieved greatness.

How did their career journey begin?(Optional)First jobs, early mentors, initial spark or calling

Key Roles & Positions Held(Optional)Major titles, promotions, relocations, or business ventures

Major Accomplishments & Defining Projects(Optional)Significant initiatives, patents, landmark cases, built structures, or records

Challenges Overcome & Changes Witnessed(Optional)Navigating industry shifts, crisis leadership, technological changes

Colleagues, teams, mentors, and communities touched along the way.

Colleagues & Work Friends(Optional)Close teammates, work partners, lifelong friends

Mentors, Leaders, & Inspiration(Optional)People who influenced or championed the retiree

Teams Led, Mentored, or Served(Optional)Students, apprentices, younger colleagues, clients, or patients

Stories or Messages from Coworkers & Family(Optional)Tributes, funny anecdotes, or well-wishes from peers

The lasting imprint they leave on their field and community.

Key Contributions & Lasting Impact(Optional)What they built, improved, or transformed

Values & Work Ethic Demonstrated(Optional)Integrity, mentorship, excellence, humor

What will they always be remembered for?(Optional)Their defining legacy among peers and loved ones

Humor, workplace traditions, signature catchphrases, and quirks.

Humor, Personality, & Signature Traits(Optional)Endearing habits, desk quirks, work style

Workplace Traditions & Catchphrases(Optional)Favorite sayings, Friday rituals, office running jokes

Meaningful Symbols, Tools, Awards, or Places(Optional)A favorite corner office, signature hard hat, special award, coffee mug

Plans for retirement, creative direction, and contact details.

Retirement Plans & Dreams(Optional)Travel, golf, grandchildren, woodworking, gardening, volunteering

What are they most looking forward to?(Optional)Relaxation, time with family, new adventures

Desired Emotional Tone(Optional)

Surprise Status(Optional)

Music Preferences & Meaningful Songs(Optional)Favorite artists, classic rock, jazz, acoustic, celebratory anthems

Closing Message or Dedication(Optional)A final toast, thank you, or blessing for their next chapter

Your Name (Primary Contact)The person submitting this form

Your Email AddressWe will send updates and project links here

Your Phone NumberFor questions or delivery confirmation

Target Delivery / Event Date(Optional)When is the retirement party or celebration?

Media Links (Google Drive, Dropbox, iCloud)(Optional)You will also receive a private gallery upload link

Authorization: I authorize DCA Works to use the provided information and media assets to produce our custom story project.

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