Circles of Support Registration

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Please fill out the following form to register for our cancer support group Circles of Support. Our 8-week groups beginnings in April!

Our English group begins on Wednesday, April 15 at 6PM.

Spanish speakers group beginning on Tuesday, April 28 at 6PM.

Both sessions run weekly and are two hours long. They will take place at the YWCA Intergenerational Center

(3450 NW 199th St, Miami Gardens, FL 33056).

Once you have registered, we will reach out with additional information.

If you have any questions, please email: healthedumgr@ywcasouthflorida.org

First & Last Name/ Nombre *

Email/ Correo electrónico *

Address/dirección de casa *

Zip code/código postal *

Phone number/número de teléfono *

Gender/género *

Female

Male

Prefer not to say

Preferred language/ Idioma *

English (Begins April 15, 2026)

Spanish (Begins April 28, 2026)

Required

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report