Name of your first loved one and your relationship with him/her / Nombre te tu ser querido y parentezco *
Your answer
Name of your second loved one and your relationship with him/her / Nombre de tu ser querido y parentezco
Your answer
Name of your third loved one and your relationship with him/her / Nombre de tu ser querido y parentezco
Your answer
Would you like to help during Mass (bringing the gifts or flowers up to the altar)? / ¿Te gustaría ayudar en la misa *
Required
Would you feel comfortable sharing your experience on dealing with loss? / ¿Te sentirias cómodo comparitendo tu experiencia de perder a tu ser querido? *
What language do you speak? /¿Qué idioma hablas? *
Your answer
Would you like to receive the monthly newsletter from the Office for Life, Peace and Justice? / ¿Te gustaría recibir comunicados de nuestra oficina? *
Would you be interested in participating in a support group for survivors of suicide loss? / ¿Te gustaría asisir a un grupo de apoyo? *