~Cycle Charting Course Interest Form~
Hi, I'm so happy that you're interested in signing up for my cycle charting course!  This is an amazing opportunity to learn how to chart your cycle, gaining invaluable insight on your overall cycle health and empowering you to avoid or achieve pregnancy.

This will teach you body literacy practices that will transform your life and your relationship with your cycle.

The course includes:
-6 hours of class material spread out over 3 weeks
-3 1 hr individual sessions 1x per month to review your charts and make sure you feel confident in your charting practice

As a student intern at The Well (www.graceofthemoon.com) this will be my first time teaching the Fertility Awareness Method.  Because of that, this course is being offered at an incredible cost of $100-$150 sliding scale (a regular class series like this would be at least $500+). Payment plans can also be arranged if needed.

I will have my mentor, a previous graduate of The Well, working with me and ensure that you will be in good hands!

After you fill out the initial application, I will be in contact around how to move forward from here.

Thank you for taking the time to fill out this form.  It should take no longer than 5-10 minutes to complete ♥️
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What is your full name *
Email *
What is your age? *
What is the best way to contact you? *
If phone is your preferred contact method, please provide your phone number
How familiar are you with charting with Fertility Awareness Methods? (Check all that apply...)
 *
Required
If you do currently chart, what do you make note of? (Check all that apply...) *
Required
Why do you want to use this method? (Check all that apply...)
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Required
What do you hope to gain from learning to chart your cycle?
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Do you have any blocks or hesitancy around learning to chart your cycle?
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How connected do you feel to your cycle, your body, & your womb? Scale of 1-5. 
1 being disconnected and 5 being deeply connected
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Required
Are you currently pregnant or breastfeeding?
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Required
Are you currently using birth control?  If yes, what kind?
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In order to learn fertility awareness, you need to be off of birth control (copper IUD is okay).  If you are currently using birth control, are you willing to stop taking them in order to learn to chart your cycle?
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If selected, are you 100% committed to completing the entire course including the class series and 3 follow up 1 on 1 session?
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Required
Do you have the time, energy and mental capacity to learn and apply a new skill?
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Please select the days and times you are most available to attend all live classes. Classes will begin in May. Classes will be approximately 2 hours long. Based on participant entry, I will select the day and time frame that suits the group the best. Please select BOTH the days and the times that work for you. Feel free to suggest any other times in the 'other' section. All times are in EST. *
Required
Do you prefer an in person or online learning environment? *
Is there anything else you would like for me to know?
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