Navigation

Personal Information Form

Personal Info Form

Please complete this form and send it back to us. After we review it we'll get back to you with any additional questions or comments we may have. Our intention is to have a conversation with you to help determine if our retreats are likely to meet your needs and expectations. We'll begin this conversation by email, but at any time we're also available to have a telephone conversation.

Name(Required)
What is your primary reason for wanting to attend one of our retreats?(Required)
Are you comfortable being anonymous? In our retreats, participants don't use their real names. Instead, they use pseudonyms. We do this for many reasons, one of which is that we don't want people to define themselves based on their past stories, job description, or any other label. Do you think you'd be comfortable being anonymous for a few days?(Required)