Trifecta Women's Leadership Retreat
Please complete the application. An invoice will be sent to your billing person/address of choice.

May you feel empowered, stay engaged, and touch enlightenment. See you in January!

Name *
Your answer
Pronouns *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
Mailing Address *
Your answer
To whom should we bill your invoice? (Name & Email) *
Your answer
Is your employer/company sponsoring the event? *
If "no" are you interested in getting a complimentary registration as a benefit of becoming an event sponsor?
Job Title *
Your answer
Employer *
Your answer
Do you have a request for a specific roommate? If so, please put her name below. If not, leave blank.
Your answer
Do you want to upgrade to a private room? We will add $135 to your invoice and you will stay in a single king room. *
Do you identify as a woman and/or femme?
Why do you want to attend the Trifecta Women's Leadership Retreat? *
Your answer
What is frustrating you or holding you back right now? *
Your answer
What is inspiring you and moving you forward right now? *
Your answer
Do you have any need for us to make a reasonable accommodation for you to successfully participate in the event? If "yes" then please explain. If "no" then move on to the next section.
Your answer
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