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* 1. What is your name?

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* 2. What email address would you like to use for communication?

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* 3. What is your phone number? (Optional)

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* 4. I heard about SOAR for Women

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* 5. Are you familiar with attachment theory related concepts?

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* 6. Are you interested in attachment theory related concepts?

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* 7. Personal interests include (but are not limited to ...)

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* 8. This is my first time joining a women’s only group.

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* 9. Topics I’d like to explore with the group include:

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* 10. Things that are off the table, not up for discussion ….

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* 11. The reason I’m joining this group is to

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* 12. Is there anything else you’d like to share?

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* 13. Do you have questions that you’d like to ask Rosanne?

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* 14. Before I commit to joining S.O.A.R for Women I would like to schedule a :

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* 15. S.O.A.R for Women occurs on the same night each month, is there a day of the week that does NOT work for you?

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* 16. Which time of day is best for you?

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