Soulshine Healing in Community Group Interest Form

About the Soulshine Healing in Community Group

Soulshine: Healing in Community Group is an eight week group led by Kelly Wilt, LAC of Kelly J. Wilt Integrative Counseling & Consulting, LLC and Director of Soulshine. The Healing in Community group centers community and space where people who have experiences with trauma can share, learn, explore new practices, and grow with one another. The group is an opportunity to reflect on our past, our present, and our visions for the future. In this space we will honor the wisdom of each person and collective wisdom of the group. Using opportunities to grow our self-compassion, create, practice mindfulness, join in conversation, have quiet reflection, and share in nourishment, we will support each other in an atmosphere of healing and authentic community.

Please complete this form to indicate your interest in the group. Dates will be announced later in 2020. Spots are limited. The cost is $300 per person for the eight-week session. Payment plans are available. Fee includes facilitation, supplies & snacks. Participants are asked to commit to all dates and should discuss in advance with practitioner if they anticipate needing to miss any dates. Spots partially-covered by community-funded financial assistance may be available. Please contact us to let us know if you are interested in learning more about financial assistance options to attend.

Please note that by completing the form you are not committing to the group. We will reach out to follow up with all interested folks.

If you have additional questions, please don't hesitate to contact us at kelly@kellyjwilt.com.

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* 1. Name

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* 2. Please tell us a little about yourself! Passions, practices, identities, age, and anything else significant in your life that you'd like to share.

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* 3. Please tell us a little about your hope in attending the Soulshine Healing in Community group.

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* 4. Have you shared about your experiences related to healing or trauma before?

Yes

Other (please elaborate as you're comfortable)

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* 5. Talking about experiences with healing and/or trauma can often feel deeply connection-building, but can also be difficult and triggering. It can be helpful to make sure you have supports in place before and after the group so you can take care of yourself in whatever ways feel good to you. What are some supports you have in place? If you'd like to participate but are unsure if you have supports in place, please contact us at kelly@kellyjwilt.com.

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* 6. Email Address

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* 7. Phone Number

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* 8. Do you have any accessibility needs related to the environment, phsyical space, noise, allergies and sensitivities, dietary requests, or other items that would be helpful to keep in mind when creating a space that you can fully participate and feel comfortable in?

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* 9. Please feel free to use this space if there's anything else you'd like us to know.

Thanks so much for your interest! We will reach out to connect with everyone who expresses interest.