Virtual Circles of Care Application
Email *
First and Last Name *
Cell Number *
City, State *
Gender Identity / Expression *
Pronouns *
Cultural Heritages *
Religious Heritages *
Other identities you wish to share *
Tell us a bit more about you and why you want to be a part of this circle series *
1st Session Weeks of July 26th, August 2nd, & August 9th *
Which times do you prefer for this session?
2nd Session Weeks of August 16th, August 23rd, & August 30th *
Which times do you prefer for this session?
How did you learn about Exhale/this series? *
What experience (if any) have you had with Circle practice? *
What would you like to get from participating in this circle? *
What would you like to contribute while participating in this circle? *
Can you agree to basic group agreements such as confidentiality, respect, open participation, honest feedback? *
Is there anything else you want us to know? *
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