Volunteer Grief Mentor Application

If you have survived or lost a loved one in an air disaster and would like to help others through their grief by becoming an ACCESS Volunteer please fill out the form below.

(Click here to read more about Volunteer Grief Mentoring)

    First Name: *

    Last Name: *

    Address: *

    City: *

    State: *

    Zip Code: *

    Country: *

    Daytime Phone:

    Evening Phone:

    Mobile Phone: *

    Your Email: *

    Your Age:

    I lost my (relationship):

    Name(s), Age(s) of Loved One(s):

    I survived an air disaster

    Air Carrier/Flight Number:

    Location of Incident:

    Date of Incident:

    Departure City:

    Destination City:

    I'm able to volunteer via (check all that apply):
    Phone
    Email
    Post

    Contact Me:
    Contact me by phone
    Contact me by Email

    Best time to contact you?:

    How did you hear about ACCESS?:

    Do you have children or other dependents? (Please list their names and ages):

    Your Occupation:

    Your Special Interests:

    Are you involved in any air disaster groups? If so, which ones?

    Have you created Memorials for your loved ones? If so, please describe:

    Profile

    Please include as much information as possible about your unique experience to help us better match you to an individual in need. (For example: your methods of coping and your reactions to the disaster are especially helpful to us)

    If you prefer to follow a framework there are some suggestions below. These are only guidelines and you should feel free to elaborate.

    Please describe your loved ones relationship to you and a brief background about them -- profession, age, hobbies, anything else that you consider to be of importance in order to describe them:

    How did you learn of the disaster? Could the information have been relayed better? Was the timing and method appropriate?

    What helped you the most in getting through the first hours, days, weeks and years following your loss?

    Who have you turned to for support? (Other victims, family members, counselors, people of faith) How have they helped you?

    What have been the most difficult roadblocks in your journey and how have you overcome them?

    What comments, words or phrases did people say to you that were helpful following your loss? Which were hurtful?

    What do you know now that you were not previously aware of that would have helped you following your loss?

    What do you think would be the most helpful advice to give someone who has just lost a loved one?

    Anything else you would like to share?

    *I have read and agreed to the Terms of Volunteer Grief Mentoring

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    You may also download a copy of this form and mail it to ACCESS.

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    Surviving Sudden Loss: Stories from those who have lived it

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    Families We Have Helped:

    Below are some of the air disasters that we have responded to:
    Private Plane - 9/26/12
    Rockingham County, VA
    Private Plane - 2/27/11
    Abu Dhabi
    Private Plane - 12/22/10
    Barrington, NY
    Private Plane - 7/17/10
    South Portland, ME
    Air India Express 812 - 5/22/10
    Mangalore, India
    Afriqiyah Airways 8U771- 5/12/10
    Tripoli, Libya
    Ethiopian Airlines 409 - 1/25/10
    Off of Na'ameh, Lebanon
    Air France Flight 447 - 6/1/09
    Atlantic Ocean
    Turkish Airlines Flight 1951 - 2/25/09
    Amsterdam Airport Schiphol
    Continental Flight 3407 - 2/12/09
    Clarence Center, NY
    US Airways Flight 1549 - 1/15/09
    Hudson River, NY
    Aeroflot Flight 821 - 9/14/08
    Perm, Russia
    Spanair JK 5022 - 8/20/08
    Madrid, Spain
    TAM Airways JJ 3054 - 7/17/07
    São Paulo, Brazil
    Comair Flight 5191 - 8/27/06
    Lexington, KY
    Airbus A320-211 - 5/3/06
    Off Sochi, Russia
    Bellview Airlines - 10/23/05
    Nigeria
    West Caribbean Airways 708 - 8/16/05
    Machiques, Venezuela
    Air France Flight 358 - 8/2/05
    Ontario, Canada
    Kam Air Flight 904 - 2/3/05
    Pamir Mountains, Afghanistan
    Corporate Airlines 5966 - 10/19/04
    Pettis Township, MO
    Kish Airlines Flight 1770 - 2/10/04
    United Arab Emirates
    Georgian Express Flight 126 - 1/17/04
    Ontario, Canada
    Flash Airlines 604 - 1/3/04

    Red Sea

    Turkish Airlines 634 - 1/8/03

    Diyarbakır Airport, Turkey

    US Airways Express/Air Midwest Flight 5481 - 1/8/03

    Charlotte, NC

    American Flight 587 - 11/12/01

    Queens, NY

    The events of September 11, 2001

    Private Plane - 12/3/00
    Milltown, WI
    Singapore Airlines 006 - 10/31/00

    Chiang Kai-shek Internat'l Airport

    Gulf Air Bus A320 - 8/23/00

    Persian Gulf, Bahrain

    Air France Concorde 4590 - 7/25/00

    Gonesse, France

    Alaska Airlines 261 - 1/31/00

    Pacific Ocean

    Egypt Air 990 - 10/31/99

    Atlantic Ocean

    American Airlines 1420 - 6/1/99

    Little Rock, AR

    Swissair 111 - 9/2/98

    Atlantic Ocean

    Private Plane - 8/4/98
    Phillips, WI
    TWA 800 - 7/17/96

    US Air 427 9/8/94

    Allegheny County, PA

    Long Island, NY

    Pan Am 103 - 12/21/88

    Lockerbie, Scotland

    TWA/United Airlines - Mid-Air Collision- 12/16/1960
    Brooklyn & Staten Island, NY
    and hundreds of other private, commercial and military air disasters

    See Full List