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Please fill out and submit the following form if you are interested in training to be an I-Beam.

If you prefer to mail your information to Normal Moments, please print this page, fill in all information, and send it to:

NormalMoments, Inc
c/o Tricia Fragen
1318 Baylor Ct
Naperville IL, 60565

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First Name: Last Name:

Street Address:

City State Zip Code

Email Address Phone Number

How did you hear about Normal Moments

All personal information you provide is confidential and will not be shared. Please view our Privacy Statement for complete information

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Please fill in the following information so that we may better match you to a family in need.

My child has/had .

My child's current status is: Please select an option Cured In remission Currently in treatment Deceased .

My child is/was treated for: years.

We have had treatment/consultation at the following hospitals: .

Other comments:

Please check if you are willing to take phone calls 24/7.

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Please select if you agree to the follwoing terms. Please Select I agree

I am aware that all I-Beams must attend a partial-day training program and sign a confidentiality waiver.

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When you hit the submit button, this form will be submited.