Registration

Interested in attending a group? If you are interested in attending a Facing the Future support group, please register your interest by completing the form below. Please read the 'How we use your data' section of our Privacy Policy to ensure that you are happy to proceed before registering.    One of our volunteers will try to call you as soon as possible, to give you all the information you need to help you decide if the groups are right for you. The call may come through on a blocked or withheld number.  If we are unable to contact you after three attempts, we will email you asking you to confirm the best number and time to call you. If we do not hear from you within four weeks of the date of our email we will remove your details from our system. Naturally if you still wish to participate in Facing the Future, you are welcome to register your interest again.  We will also give you more information on when groups are expected to start in your area, so you can plan them in around your other commitments.   The importance of the first session At the first session participants will meet each other and the facilitators for the first time. It can be disruptive to the group if a new group member joins at a later stage, therefore it is a condition of the group that participants must attend the first session. Please consider this discussing the group dates during your call with our volunteer.

All fields marked with an * are mandatory.

Title*	--None-- Mr. Mrs. Ms. Miss. Mx. Dr. Prof.
First name*
Surname*
Age*	--None--18-25 26-30 31-35 36-40 41-45 46-50 51-55 56-60 61-65 66-70 71-75 76-80 81-85 86-90 91-95 96-100
Gender	--None--Male Female Prefer Not to Say
Email*
Contact Phone Number*
Instructions for calling e.g. - call after 7pm*
If you are unavailable, is it OK to leave a voicemail?*	--None--Yes No
Name of deceased*
Relationship to deceased*	--None--My Partner My Spouse My Parent My Child My Sibling Other Family Member My Friend My Work Colleague No Prior Relationship
Length of time since bereavement*	--None--0-3 Months 3-6 Months 6-9 Months 9-12 Months 1-5 Years 5-10 Years 10+ Years
Preferred location*	--None-- Devon (Exeter) East Sussex (Brighton) Essex (Basildon) Essex (Southend) London (Central) Tyneside (Newcastle) West Midlands (Coventry) Yorkshire (Wakefield) Yorkshire (York)
How did you hear about this service?	--None--Link from Cruse Website Link from Samaritans Website Referred by Cruse Referred by Samaritans Referred by Friend / Family Referred by G.P. Referred by Other Organisation Media Local advertisment Search Engine Other
Please tick this box to indicate you have read and agree to our Terms and Conditions and Privacy Policy*
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