Completing this form will add your contact information and event to the nation-wide listing of When Grief is Complicated events. If you do not want your information or event made public, do not submit this form.

Registered Site Organization

Program Organizer Contact Name

Program Organizer Phone Number

Program Organizer Email

Event #1

Which classification best describes the area where this event will be held?

Event #2

Which classification best describes the area where this event will be held?

T