Yearly Survivor Retreat Application

The "Journey of Grace" Human Trafficking Survivor Retreat is held yearly for women 24 years of age and older who have been trafficked in the United States, been 'out of the life' for over two years and who have already worked hard to heal. 

This retreat is the Next Step in the journey of grace. The retreat is ideal for those who want to become not just survivors, but Thrivers. It is for those who need a little boost in their healing, who want to develop supportive relationships with other survivors and mentors and who are willing to work a little and love a lot. 

The weekend is a combination of letting go, having fun and laughing, and working hard on your inner self and working through triggers. There are massages, hair cuts and make overs, as well as classes on releasing your anger and forgiveness, nutrition, self defense and how to tell your story as well as group exercises on building trust. 
The weekend is totally free but because of this and our funding, we can only accept 24 women. If you aren't selected this time, we are hoping to expand it to several times a year! 

The location is located in a safe place. Everything is included and is FREE. If you live far, we will also try to help get you to it for free as well. 

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* 1. Applicant Information 

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* 2. What is your age?

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* 3. What city would you fly out of? 

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* 4. What is the highest level of school you have completed or the highest degree you have received?

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* 5. Which of the following categories best describes your employment status?

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* 6. What would your dream job be? 

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* 7. How much total combined money did all members of your HOUSEHOLD earn last year?

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* 8. Do you identify with any of the following religions? (Please select all that apply.)

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* 9. In general, how would you rate your overall health?

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* 10. How long has it been since your most recent visit with your healthcare provider?

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* 11. Do you currently have health insurance, or not?

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* 12. Do you currently smoke cigarettes, or not?

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* 13. How many hours do you sleep each night?

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* 14. Do you have any dietary restrictions? If so what are they? 

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* 15. Do you have any allergies? If so, what? 

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* 16. In general, how would you rate your overall mental or emotional health?

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* 17. Do you have any physical injuries or disabilities? If so, do you need assistance? 

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* 18. Have you been in a recovery program?

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* 19. What medications are you currently taking?

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* 20. Why do you want to attend the retreat? What do you hope to get out of it? 

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* 21. Tell us about your story- being trafficked. Please tell us as much as you can so we can get to know you better. 

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* 22. what are your triggers? (if you know) How do you handle them? 

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* 23. Are you in counseling? If so, what type and how often? 

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* 24. Who are your support people?

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* 25. Reference #1

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* 26. Reference #2

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