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* 1. Name and Email

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* 2. Age Group

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* 3. Religious Background and/or Affiliation

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* 4. I currently belong to a faith community (church, temple, etc).

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* 5. How did you hear about The Walk? 

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* 6. What has motivated you to consider taking this course? What are you hoping to gain from or give to this experience?

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* 7. The Walk is a spiritual, financial, and time investment, and may have a strong emotional component. Please indicate below your readiness to engage the full process.

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* 8. I have experienced or am experiencing a significant episode of doubt, "distance from God," and/or loss of faith.

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* 9. If you have answered "yes" to the above question, please describe. Are you willing to share about this over time in your cohort?

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* 10. I have gone through trauma in a faith community that I feel I will need special help in processing, and I will discuss this with Jenn prior to the start of class.

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