GriefShare Registration Form
GriefShare will meet Thursday evenings from 6:30-8:30 starting January 17.
Email address *
Your Name
Your answer
Street Address
Your answer
City, State, Zip
Your answer
Phone Number
Your answer
Date of birth (Month/Year)
Your answer
How did you hear about GriefShare?
Your answer
Please share a little about the person you lost and when the loss occurred.
Your answer
Registration Fee: $20 (includes workbook and other expenses during all 13 weeks of sessions)
Please bring your payment to the first meeting or contact us if you need a scholarship
Submit
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