The Actively Moving Forward® (AMF) App Registration Form

Registration

Thank you for your interest in the AMF App! The purpose of the App is to provide grieving individuals, professionals and volunteers who serve them an opportunity to join a virtual community. The purpose of the community is to provide a platform to connect and share with other like-minded individuals grieving or supporting those who are.

The App is set up as a “Closed” membership, requiring registration. Please fill out this form with the required information and we will send you the login credentials once it's been approved.

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* Your contact information (Answers to bolded fields will be visible in the profile section of the App)

First Name *

Last Name *

City/Town *

State/Province *

ZIP/Postal Code *

Country, if NOT in the United States

Primary Email Address *

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* Phone number, including country code, in the following format: e.g., 18005551234. Please do not include spaces or symbols.

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* Re-enter your primary email address

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* Date of Birth: MM/DD/YY (e.g., 01/23/1995). (For internal use ONLY)

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* Tell us which community best serves you.

I am a grieving young adult, aged 18-30

I am a grieving adult OVER the age of 30

I am a professional/individual supporting grieving individuals