JLD Community Support Circle - Interest Form
Have you or someone close to you been affected by gun violence? At JLD Community Solutions, we're exploring the creation of a supportive space for individuals and families in the Lexington and surrounding area who have lost loved ones to gun violence. This group would provide a safe space for healing, connection, and collective strength. Whether you're ready to share, listen, or simply show up - you're not alone. Please complete this brief form to let us know if you'd like to be involved in a future support circle or related resources.
Full Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Email
*
example@example.com
Preferred Method of Contact
*
Email
Phone
Text
Are you a Lexington (or Davidson County) resident?
*
Yes
No
Have you personally been impacted by gun violence?
*
Yes - I've lost a loved one
Yes - I've been a witness or survivor
No, but I care about this issue and want to help
Would you be interested in attending a support group in the future?
Yes
No
Maybe
How would you prefer to attend a support group?
In-person
Virtual
Either is fine
What days/times work best for you to meet?
What would you hope to get out of being part of a support circle?
e.g. handling hazardous material, waterproofing, demolition
Is there anything else you'd like to share with us?
e.g. handling hazardous material, waterproofing, demolition
Submit
JLD Community Solutions
Empower. Educate. Engage.
Email
: support@jldscholarshipfund.org
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