Gilda's Club Lowell LaughFest Grand Rapids Cancer Support Communities

Cancer Member Intake

   

Welcome to Gilda's Club Grand Rapids Member Information

Gilda’s Club Grand Rapids welcomes you as a Member of our cancer support community. We are glad that you walked through our red door and hope that you will find opportunities to learn, share and find some laughter during this journey. The following information will help us get to know you better and provide insights on what you might find of greatest value at Gilda’s Club.

 



 

Cancer Related Information

Please complete these fields as they pertain to you or the person you are supporting.


Supporters, tell us who you are supporting.


Demographics


 

The demographic information you provide will assist Gilda’s Club in our effort to seek funding from foundations/grants that help ensure our activities remain free of charge. Individual data will not be shared, rather collective group statistics will be utilized.



Emergency Contact Information