Registration for 2019-2020 Courage to Teach Series
Complete this survey to register for the 2019-2020 Courage to Teach Season Series at the Santa Sabina Center in San Rafael, Ca.

Dates of the Retreats: Feb 15-17, 2019; March 29-31, 2019; July 5-7, 2019; Sept 27-29, 2019; Feb 14-16, 2020

As part of this registration process, please write a Personal Statement (not more than two pages) to help us get to know you before the retreat. You will be asked to upload your writing in the last question of this form. So it is best to write the statement prior to completing this form.

In your personal statement, please include:

• How you learned about this retreat series.

• Why you are interested in participating, and how you hope to benefit personally and/or
professionally.

• The setting in which you currently do your work.

• A question you are currently holding about your life or vocation.

After you complete this form, we ask that you make your $750 deposit today on New Leaf Collaborative website.

Email address *
First and Last Name *
Mailing address *
Email *
Phone Number *
Have you participated in a seasonal series before? *
Are you available for all 5 retreats? *
What is your primary role as an educator? *
Required
Special Dietary Needs (if any):
Please upload your Personal Statement. *
Required
Cancellation Policy: 1. You will be billed for 50% of the total room and meal fees when cancellation is received 60-90 days prior to the retreat date. 2. If cancellation is received 30-60 days prior to the retreat date, you will be billed for 75% of total room and meals. 3. If cancellation is received 30 days or less prior to the retreat date, you will be billed for 100% of total room and meals. *
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