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MACGV Support Group Intake Form

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WELCOME 

Thank you for your interest in Mothers Against Community Gun Violence (MACGV) support groups for parents and siblings of children whose lives were taken by community gun violence. If you are a sibling under the age of 19, please email iammydaughterskeepernb.com to register for the group. We have various support group options that are excellent sources of help for parents and siblings navigating the ongoing trauma and pain of losing a child, sister, or brother to gun violence. Our support group facilitators are licensed, trained therapists or recovered gun violence victim-survivors. MACGV's groups provide an opportunity to meet others who genuinely understand one another's Loss and build bonding friendships. 
There is no fee to participate.

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We look forward to welcoming you to one (or more) of our groups!
 

Support Groups

I am interested in the following group(s):

Contact Information

Would you like to receive text messages from MACGV at the mobile phone number provided? Message and data rates may apply.
How did you find out about Mother Against Community Gun Violence

Birth date of your child lost to community gun violence 

Please share the date your child’s life was took by community gun violence

The age of your child at the time of their transition/passing

Your child's gender

Court Case Supportive Information (Optional)

The information you provide will help us identify how we can better serve you, and help us establish goals for broadening our reach and support. Thank you for helping MACGV collect this important data.

Upload any relevant documents.
If you lost your child to homicide, has there been an arrest made?
Has there been a conviction?

How long did your trial process take from start to finish?

How many years did the murderer of your child receive?

If no conviction, how often are you in touch with the detectives? 

How would you best describe your race or ethnicity? (Please check all that apply.)
How would you best describe the race or ethnicity of your child? (Please check all that apply.)
What is the primary language(s) spoken in your home? (Please check all that apply.)

Thank you for taking the time to fill out the Mothers Against Community Gun Violence (MACGV) support group intake form. We will review your responses and send you a follow-up email with further information within one week. If you have questions in the meantime, please feel free to contact our Intake Coordinator at candiceboneta@gmail.com 

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**If you don't receive an email within one week, please check your spam folder
 

Your Application has been submitted

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