Day of Mourning Site Coordinator Sign-up
Site coordinators are a vital part of the Disability Day of Mourning. Site coordinators secure space in their communities to hold a vigil, do outreach to community members leading up to the vigil, and document their vigils through pictures or videos to honor those lost to filicide. To learn more about what kind of work is involved in coordinating a vigil, please consult our Site Coordinator's Guidebook: http://bit.ly/2ERV3CT

Please fill out the following information if you would like to coordinate a vigil for Disability Day of Mourning, to take place on Thursday, March 1st, 2018. If you do not submit your information using this form, you will NOT receive the list of names for this year, or our check-in emails for site coordinators.

Name of site coordinator *
Your answer
Name you would like us to put on our website (if different than above)
Your answer
Email address *
This will serve as your point of contact for people with questions about your vigil, as well as where ASAN will communicate with you regarding the vigil (including distributing the list of names). Please use an email address that you are comfortable with us listing on our website.
Your answer
Location of vigil (City and State) *
Your answer
Submit
Never submit passwords through Google Forms.
This form was created inside of Autistic Self Advocacy Network. Report Abuse - Terms of Service - Additional Terms