Apply Main First Name* Last Name* Date of Birth* (DD/MM/YYYY) Email Address* Confirm Email Address* Please choose a password (min. 8 characters) Password* Confirm Password* Tick this box to accept The Last Resort Privacy Policy By clicking on Register your information will be securely saved and you will be able to revisit it any time by using your self-chosen secure log-in details. Should you go forward with an accompanied suicide at The Last Resort this information will be printed and filed (for future possible reference by the Swiss authorities). The online data will be deleted. Register If you are under 50 years, please do not apply as your application will not be considered. After registration, you will be able to log in to complete your application Already Registered? Login Questions? See FAQs
