Navigating Grief After Homicide

Navigating Grief After Homicide

Information and Support Group for Loved Ones of Homicide Victims
Registration Form

Tuesday, March 21, 2023 from 7:00 PM – 8:30 PM
Registration is required for each meeting so that we can better plan for participants.
First Name*
Last name
Phone Number*

Area CodePhone Number
Email*
example@example.com
Optional Information (please only complete once - if you have attended the group before there is no need to repeat this information)
What is the name of your loved one who was taken by violence?
I am my loved one's _________ (mother, father, son, daughter, brother, sister, friend, etc.).
When did this homicide occur?
Where did this homicide occur (city, county, state)?
In what county and state do you currently reside?
What else do you want us to know about you, your loved one, or what happened??
How did you learn about our support group?

NewspaperOnline AdNCVAN WebsiteReferred by law enforcement or prosecutorTherapist or clergyFriend or family member
Do you have any upcoming court dates? If so, when and where?
Would a different day and/or time make this support group easier for you or others you know to participate? If so, please add options.