Name

First Name

Last Name

Please confirm you are 18+ before proceeding by ticking the box below.

Yes, I am 18+

By ticking this box, you confirm that you have read the mentoring and terms and conditions decks and understand the offering in full. (If not, please head back to the main mentoring page to have a read and return back here!) *

Yes, I have read the mentoring deck in full and understand the offering.

Do you consent to The Grief Gang LTD to contact you regarding your mentoring application via email? *

Yes

No

If interested in group circles, please select below which groups you are most interested in joining (Choose as many that apply) *

General loss (A mixture of different loss experiences)

Mother loss

Father loss

Parent (both) loss

Sibling loss

Partner loss

Friend loss

Baby loss

Child loss

In person (A mixture of different loss experiences))

Other