Lifeline Form

The Compassionate Friends of Southwestern Manitoba

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Lifeline

Whether you are a parent, grandparent, family member or professional seeking more information about The Compassionate Friends or to have a child remembered in our newsletter or on our website please fill out the form below.

The Compassionate Friends has no membership fees- the price of membership is the loss of a child, which makes TCF the most expensive in the world. We are incorporated as a charitable organization and are supported by voluntary, tax deductible donations.

The Compassionate Friends has no membership fees- the price of membership is the loss of a child, which makes TCF the most expensive in the world. We are incorporated as a charitable organization and are supported by voluntary, tax deductible donations.

I am/we are: *

Parents Grandparents Professional Chapter Leader Sibling Other

If Other please specify: *

Your Name *

Your Mailing Address *

P.O. Box
Town/City
Province
Postal Code

Your Email Address *

Your Phone Number *

Child's name *

Child's name (m/f)
Date of birth (m/d/y)
Date of death (m/d/y)
Cause of death

I/we wish our child to be acknowledged in "Our Child Remembered" *

Yes No

Surviving siblings: (select all that apply) *

Pre school 6-12 years of age Teen Adult

IMPACT STORY *

If you are comfortable, please submit a comment about how The Compassionate Friends has impacted your life.

May we share your comments in a Lifeline Newsletter and on our website? *

Yes No

For professionals seeking additional information *

Please enter:
Preferred mailing name
Profession
Contact person

Professionals *

I would like TCF to make a presentation to my collegues I would like brochures which I would display

'We need not walk alone'