Registration

Woodmen Valley Chapel – Colorado Springs, CO

Starting Date:

Monday September 9, 2024, at 10:00 a.m. (Mountain Time) (11:00 CST/12:00 EST)

Facilitator:

Kim Raymond

Modality:

In Person

Location:

Woodmen Valley Chapel – Elementary Bldg. in Room 202

Language:

English

Available Spots:

First Name*

Enter your First Name

Last Name*

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Birthdate*

Email Address*

Phone Number*

Line Type*

Mobile

Landline

Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

How long were you married?*

How long have you been a widow?*

Husband's first name and date of death*

Preferred Language*

English

Spanish

Other

Preferred Method of Communication*

Text

Phone Call

Facebook Messenger

What activities do you enjoy doing?*

Activities, hobbies, etc.

What are your expectations of this group?*

What does your immediate family look like?*

Children, grandchildren, siblings, etc.

How did you hear about this group?*

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