New Member Interest Form

  • If you are interested in Cancer or Grief Support at Gilda’s Club Grand Rapids or Gilda’s Club Lowell, please complete this form and our Program Staff will contact you with more information within one business day. If you need an immediate response, or you do not receive a response from us, please give us a call at 616-453-8300 or email us at register@gildasclubgr.org. Thank you for your interest and we look forward to welcoming you soon!
  • Cancer Support Interest

    Please complete this section if you are interested in receiving information about our cancer support programs. Leave blank if this does not apply to you (Grief Support info below).
  • Grief Support Interest

    Please complete this section if you are interested in receiving information about our grief support programs. Leave blank if this does not apply to you.