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* 1. Name

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* 2. Email

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* 3. Age Group

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* 4. Religious Background and/or Affiliation

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* 5. How did you hear about Stepping Into the Story? What has motivated you to consider taking the Step?

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* 6. Stepping Into the Story is an emotional, spiritual, financial, and time investment. Please indicate below your readiness to engage the full process.

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* 7. I have reflected on the dark side of my life and will be able to address that in my Life Map.

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* 8. I have gone through a traumatic experience 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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* 9. Preferred Day and Time

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