Self, Spirit. Community Application

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* 1. Name

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* 2. Phone Number

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* 3. Email

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* 4. How did you hear about this body based healing group?

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* 5. What communities do you identify with?  How do you experience social contexts of trauma and oppression impacting your life and communities?

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* 6. How do you hope your participation in this group will support your healing and participation in community?  Are there particular issues that you are working on at this time? 

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* 7. What healing work have you previously participated in?  What was beneficial and what has been challenging? What kind of support do you currently have access to?

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* 8. How would you describe your community work or involvement?

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* 9. We ask that participants attend all 11 group sessions and commit to daily body-based practices.  Can you do this?  What challenges or benefits do you anticipate?

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* 10. By applying, you are agreeing to pay $725 for the whole group or applying for a scholarship. You will pay the amount you committed to whether or not you can make it to every group. We can take a credit card or figure out a payment plan. Can you make this financial commitment? Would you like to apply for a financial scholarship? (If so, let us know if you will apply for one of two spots at $360 or if you want to apply for the pay-what-you-can spot. 

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