Application for The Work That Reconnects Facilitator Development Program - 2017 -18
Email address
First Name
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Last Name
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Phone Number
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Street Address or PO Box
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City
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State or Province
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Postal Code
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Country
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Social Identities:
As part of our work in this course, we will be exploring different facets of our biological and socialized identities, including areas of privilege and oppression. Because it will help the facilitators to better plan for our work together--and because we hope it will be a meaningful reflection for you on some of the circumstances of your life--we ask you to share some information about how you identify. Please respond in whatever way feels accurate and comfortable for you at this time in your life.
Gender Identity
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Racial Identity
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What lands/nations/countries are your ancestors from?
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Country or countries of residence and/or citizenship
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What is your first language?
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Background in Facilitation and the Work That Reconnects
What is your experience with facilitation? What are your strengths and what do you want to learn?
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What is your experience with the Work That Reconnects? What workshops or retreats have you attended--when, with whom, for how long?
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How has the Work That Reconnects affected your life and goals?
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How do you plan or hope to use the Work That Reconnects?
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What calls you to do this work at this time?
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Logistics
We estimate the cost of the year-long program to be between $800 and $1200, not including the costs for the closing weekend (to be determined later). We may be able to offer a few scholarships. How much of that cost will you be able to cover?
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To help us schedule webinars, please tell us days or times over the next year when you foresee you could not attend. Please include your time zone.
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A copy of your responses will be emailed to the address you provided.
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