Ladies Luncheon (Mechanicsburg) – Registration

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The Journey Program and the Pathways Center for Grief & Loss are free resources to our service area region, regardless of whether your loved one is or was a hospice patient. Our support groups focus on grief education and support and are designed for those within the first two years following the death of a loved one. Registration deadline is one week prior to the group.

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User Name

MRN#(Required)

HB/CB?(Required)

Is this your first time attending a Journeys or Pathways support group or luncheon?(Required)

Yes

Your Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Your Telephone #(Required)

Your Email(Required)

When was your loss?(Required)

Was your loved one under the care of Hospice of Central PA or Hospice & Community Care?(Required)

Yes

What was his/her name?(Required)

First Last

Select the date for which you would like to register. (Only one date may be selected per submission.)(Required)

Registration deadline one week prior to the luncheon.

September 22, 1:00-3:00 pm (12 spots left)

October 27, 1:00-3:00 pm (12 spots left)

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