Grief Support Group Interest Form

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Please complete the form below if you would be interested in having your child participate in a school based grief support group facilitated by Peter's Place during school hours. By completing this form, you are solely expressing potential interest and not committing to having your child participate. After receiving feedback on interest from parents, we will send home official permission forms for the selected students.

Email *

Student Name:
*

Student Grade:
*

Student's Middle School:
*

William Penn

Charles Boehm

Pennwood

I am interested in possibly having my child participate in a school based grief support group.
*

Yes

Please briefly describe your child's loss (does not need to be recent) for them to participate and receive support (for example: Loss of grandparent in 2018, loss of sibling in 2020, etc.)
*

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