Sexual Attitudes Reassessment Registration
Provider: Linda Weiner, MSW, LCSW
Event Timing: January 17th, 2018
Event Address: Saint Louis, MO (specifics TBA)
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Participant Name *
Your answer
Email *
Your answer
Phone *
Your answer
Organization *
Your answer
Are you currently enrolled full time or part time as a student? *
Dietary restrictions *
Please tell us: Your degree(s); current employment (please include area of practice, years in field, title, practice setting, and client population, if applicable); a short description of your professional or educational experience, particularly in the field of sexology?
Your answer
In a few sentences, why are you registering for the SAR? What are your specific goals and expectation of outcomes from attending this training? What do you hope to gain from the experience? In what areas do you hope to grow?
Your answer
Please name the top three areas of sex and sexuality you hope to be addressed at this training, and then rank your comfort level discussing the following topics, on a scale from 1 (least comfortable) to 5 (most comfortable). *
Your answer
Talking about sexuality
Self-pleasure & masturbation
Sexuality Transmitted Infections/HIV
Sexual assault
Cyber Sex
BDSM relationships
Polyamory and Ethical Non-Monogamy
Sexual orientation
Gender identity
Sexuality & religion/spirituality
Sexuality and Aging
Sexual assault and abuse
Anatomy and Sexual Functioning
Sex and disability
Please advise if you may have any particular needs or accommodations during this training. In what ways can the leaders make this training most accessible to you? *
Your answer
Next steps: Please submit a deposit of $100 to reserve your space. PayPal payments may be made to Contact Michelle Linschoten regarding other payment methods. The total cost of the SAR is $300 for students, $450 for professionals. All payments will be billed through Intimate Reconnections, LLC. If you choose to pay only a deposit only at this time, the balance is due ONE WEEK prior to the event. Cancellations received within 7 days of the scheduled workshop will not be refundable. If you must cancel your registration, please email AND as soon as possible. *
I understand that attendance at all trainings and the creation of a safe and productive community atmosphere is necessary for gaining the full educational experience of the SAR. I am aware that sexually explicit materials will be viewed and discussed throughout the program. I understand participants may elect to avoid viewing materials that may be personally objectionable or triggering. However, I understand that I must attend all discussion sessions for credit. By registering, I confirm that I will be able to fully attend the scheduled event. *
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