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Space for this workshop is limited. The workshop is specifically designed for EMS, fire, and law enforcement personnel involved with or interested in promoting emotional and psychological wellbeing within their agency or agency leaders. The workshop is not designed for individuals to work on their personal trauma or emotional and psychological issues. The workshop is a powerfully immersive experience in which we will learn how to understand, frame, teach, model, and promote emotional and psychological wellbeing within today's first responder agency. This brief application form allows us to select those who can benefit most from the retreat/workshop and become agents of wellbeing and resilience within their organization. Thank you.   

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* 1. Name:

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* 2. Title:

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* 3. Agency:

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* 4. Email address:

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* 5. Phone:

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* 6. Briefly describe your interest in this retreat/workshop:

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* 7. Briefly describe your role in EMS, fire, law enforcement, or other emergency service agencies:

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* 8. Briefly describe your first responder background and experience:

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* 9. Briefly describe any work/study/ exploration you have done in the areas of emotional, psychological, or spiritual wellbeing (being new to this topic is perfectly fine):

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* 10. What would you like to get from this retreat?

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* 11. Is your intention to take this material back to your agency if appropriate for your agency?

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* 12. If yes, how do you plan to share the knowledge that you have learned?

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* 13. Would you be willing to help the NDEMS Association spread awareness throughout the state?

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