Name *

First Name

Last Name

Partners name *

First Name

Last Name

Phone *

This is the phone number where texts are sent to.

Country

(###)

###

####

Address

This is where we will send your keepsake prompt postcards for you to give to your partner on Valentines day, their birthday and your anniversary.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Anniversary

We will send your keepsake prompt postcard on the day before the date you input. If you do not want to be sent one, leave this empty.

MM

DD

YYYY

Partners birthday

We will send your keepsake prompt postcard on the day before the date you input. If you do not want to be sent one, leave this empty.

MM

DD

YYYY

Disclaimers *

I understand that the tips and prompts from this service are for educational purposes only. They are not a substitute for professional therapy or counseling, and I agree to seek a licensed professional for serious relationship or emotional issues. I consent to receive text messages from Upliftext For Couples regarding relationship tips and prompts. I understand message frequency may vary, standard message and data rates may apply, and I can opt out at any time by replying STOP. I agree to the Privacy Policy and Terms of Service, and understand my personal data will be used only to send these messages.

Email Opt in

I agree to receive occasional emails from Upliftext with updates, and special offers. I understand I can unsubscribe at any time. We’ll only email you occasionally — no spam!