NU "Out of Darkness" Candle Campaign
By completing this form you are agreeing to participate in the Counseling Center for Wellness' Out of Darkness Candle Campaign. We will be mailing you a teal candle to the address you give us. Then you will be asked to participate in our social media campaign as well as the Out of Darkness Candle Ceremony. Please be sure to indicate your preferences below. Thank you!
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Contact info
Please provide the most up-to-date contact information below to ensure you receive your candle in a timely manner.
Your first name *
Your last name *
Are you a residential student? *
If yes, please indicate which building you reside in for the Fall 2020 semester?
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Room/Full Address (Street, City, State, Zip Code) *
E-mail *
Along with your teal candle, you will receive a remembrance label. Would you like this to be on behalf of: *
If you chose a friend or family member above, please indicate the full name of the individual to commemorate below:
As part of my participation in this month's programming I would feel most comfortable: *
Tee Shirt Size
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How did you find out about this event?
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