GriefShare Meadowbrook Baptist Church
Registration Form for classes beginning September 10 - December 3, 2018.
Registration Fee is $17.00 to cover the cost of the workbook.
Please send to:

Meadowbrook Baptist Church
C/0 GriefShare
1401 Colorado Ave
Rockdale, TX 76567

Office number 512-446-3367

You will be contacted by Malda Burns, Program Director.

Name
Your answer
Address *
Your answer
Phone Number *
Your answer
Email *
Your answer
Birthday (month/day) *
Your answer
Emergency contact (name and phone number) *
Your answer
How did you hear about GriefShare? *
Your answer
Please share a little information about the person you lost and when the loss occurred. *
Your answer
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