Headstone Application

Headstone Application

Cordale Q Handy In Remembrance of Me Foundation
Contact Name*

First NameLast Name
Contact Email*
example@example.com
Where are you from?*
How did you hear about the foundation and this opportunity?*
Please provide the name of your loved one who was lost to police or community violence (please write as you would like to appear in printed materials)*

First NameLast Name
Please upload a photo of your lost loved one*

High quality photos are preferred. Feel free to add up to 3 photos and we can choose a photo that works best for our materials.
Cancelof
Please provide the location where your loved one was lost to police or community violence*
City, State
What would receiving a headstone mean to you and your family?*
Events

Ms. Kimberly Handy-Jones has planned a weekend of events for Remembering Cordale Q. Handy July 14-17 (Note: Monday July 17 is an optional fellowship opportunity added this year).
- Friday, July 14 - Rally & Vigil
- Saturday, July 15 - Healing Circle for Family Members
- Saturday, July 15 - 6th Annual Cordale Q. Handy in Remembrance of Me Banquet
- Sunday, July 16 - Families' Church
- Monday, July 17 - Fellowship Morning
Note: Attending the Banquet on July 15th is a requirement to receive a headstone. All other events are optional.

While there is no charge for parents and immediate family members to attend the banquet, extended family members are asked to pay for their tickets at a cost of $150. (Please contact us at support@conveningtowardliberation.com if you are traveling alone and wish to bring a guest with you).

Once you have been selected to receive a headstone, you will receive a Family Registration form to collect information about your attendance during the weekend, including family member attendance and details and your travel schedule. This form will also share details on how to pay for extended family members attending the banquet.

Travel & Hotel

While we will gather details about your travel arrangements on the Family Registration Form, you are responsible for the cost and coordination of travel arrangements and room reservations.

A block of rooms has been reserved at the Courtyard by Marriott Minneapolis Downtown at a discounted rate. We will share details about the rate once when attendance is confirmed.
Agreements
I understand that a requirement to receiving a headstone is attending the Cordale Q. Handy Weekend of Remembrance events July 14-16, 2023 in Minneapolis, MN - minimally the banquet on July 15.*

Yes
Approximately how many family members will be at the banquet on July 15?*
If selected, you will be asked to share exact numbers and additional information about all attending family members.
I understand that headstones must be placed in a cemetery.*

Yes
I understand that vouchers for a standard flat headstone will be given out July 15, 2023 and headstones must be placed in a cemetery by September 30, 2023.*

Yes
I agree to take a photo of the headstone once it is placed, and give permission for the photo to be shared on the Cordale Q Handy Foundation website and other materials.*

Yes
Anything Else?
Is there anything else you would like to share with the Cordale Q. Handy In Remembrance of Me Foundation?
Should be Empty:

Headstone Application

Events

Travel & Hotel

Agreements

Anything Else?