Register for the Survivor Gathering

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Welcome, we invite you to register here for the monthly survivor gathering. You only need to complete this registration prior to your first visit to the group, not for every gathering.

We ask that you provide your email address so that we can provide the Zoom link for the event. Requesting registrations will help to create a safe space.

If you would like to receive our enewsletter, please check the box below. If you are already on our email list, you can leave the box unchecked.

We also ask for your ZIP code so that we can understand where we reach. The rest of your mailing address is optional. In the future, we may reach out with "snail mail" to thank you and keep you updated on our work.

We will never share or sell your personal information.

First Name *

Last Name *

Email address *

ZIP Code *

Would you like to be added to our email list? Leave blank if "no" of if you already receive our emails. We send 1 e-newsletter per month and 1 or 2 additional emails with requests for volunteers or resources.

Yes

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To help us plan for the gathering, how would you describe yourself?

Victim-Survivor

Family / Friend / of a Victim-Survivor

Advocate or Supporter for a Victim-Survivor

Other:

Full Mailing Address (optional)

Street Address

City

State

Submit

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