Facilitator Training Application

Forget Me Not Grief Center Program Volunteer Group Facilitator Application

Personal Information

Name:

Address:

City:

State:

Zip Code:

Phone (Home):

Phone (Mobile):

Email:

Occupation / Title:

Employer:

Emergency Contact (Name & Phone):

Special accommodations needed for training:

Training Commitment

Please note that volunteer facilitators/group leaders are required to attend all hours of the training.

Training schedule:

Friday evening 6:00 PM – 9:00 PM

Saturday 9:00 AM – 5:00 PM

Trainings held twice annually

Please check all that apply:

I am willing and able to make a one-year commitment to the Forget Me Not Grief Center Peer Support Groups for 3 hours on Thursdays from 6:00 PM to 9:00 PM, usually twice a month.I understand that after completion of training, each trainee meets with the Program Coordinator to determine fit and discuss Peer Group assignments or other volunteer opportunities.

Suggested Donation (if applicable):

Background & Experience

1. Tell us why you'd like to volunteer with Forget Me Not.

2. Describe any training or experience you have had related to grief support.

3. Does your experience include the loss of a family member or loved one through death? If so, who and how recently?

4. What do you hope to gain personally as a result of attending this training?

Agreement

Signature (type full name):

Date:

acceptance* consent I confirm that the information provided is accurate and complete and I agree to the terms.

By clicking submit, I authorize the release of personal information I have provided on this form to Forget Me Not Grief Center of Alaska for the sole purpose of providing grief support during orientation, program nights and supportive sessions.

The Forget Me Not Grief Center of Alaska

The Forget Me Not Grief Center of Alaska is a non-profit organization in Anchorage offering free community-based grief support, with a focus on children and teens.

forgetmenot.griefcenter@gmail.com

Links

About The Forget Me Not Grief Center
Our Services
Volunteer Opportunities