The Compassionate Friends Consent Form

If you choose to submit your child's or sibling's name for the "Our Children Remembered" column in the monthly Greenville Chapter newsletter, we must have your written permission. Please provide us with the information listed below at least a month in advance.  Thank you.

Complete the form below and press submit only once.

Parent(s) Name

Address

City

State

Zip Code

First Name

Middle

Last

Birthday

Death Day

Today's Date

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