When Teens are Grieving Book Request

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When Teens are Grieving books are available to school & community professionals, as a free resource, who interact directly with youth who have experienced a loss. Please complete this form to request books for yourself and others at your school.

You are allowed to request 10 books per counselor/psychologist/etc. If you request more than 10 books we will require you to list the names and positions of the additional professionals you are requesting books for. If multiple professionals at your school desire books. We ask that you submit as 1 request to help us keep our shipping costs down.

Once you have utilized your 10 copies in your community, please feel free to come back and make a request for additional copies.

First Name *

(please enter your first name)

Last Name *

(please enter your last name)

Email Adddress *

(please enter your email address, so we can contact you should we have any additional questions)

Job Title *

(please enter your job title)

County your school(s) resides in. *

Name of School you work for *

If you work for more than one school or work at the district level please enter the name of the school/district name you are having these books shipped to

Mailing Adddress *

(ie: 123 ABC Street) for the school/district name you entered above

City *

ie: Spartanburg

State *

South Carolina

Other:

Required

Zip Code *

Number of Books Requesting *

(You may request up to 10 books per psychologist/guidance counselor, if you request more than 10 books you will be required to enter additional names and job titles for documentation purposes)

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