Navigating Grief After Homicide

January 2026 meeting will be in person with a virtual (Zoom) option for joining.

Are you attending in person or on Zoom?*

In PersonZoom

Is this your first time attending?

YesNo

First Name*

Last Name*

Phone Number

Area CodePhone Number

Email*

example@example.com

Do you need an interpreter for this meeting? There is no fee for this service. If yes, please list the language below. NCVAN requires 5 days of notice to provide this service.

Optional Information: (Complete only once - If you have completed this form before, we have the information)

Name of your loved one who was taken by violence:

I am my loved one's ___________ (daughter, father, mother, son, friend, etc.).

When did the homicide occur?

Where did the homicide occur?

What county do you reside in?

What else do you want us to know about you, your loved one, or what happened?

What are some issues you are dealing with now that you might want to discuss at our meeting?

How did you learn about our support group?

Do you have any upcoming court dates? If so, when and where?

Would a different day and/or time of day for a support group work better for you or someone you know? If so, please list a few options.

Navigating Grief After Homicide

Tuesday, January 6, 2026 | 6:30 PM – 8:00 PM