February Fire - Scholarship Application
Scholarship Application for "February Fire: Women's Winter Workshop to Ignite Action and Spiritual Growth"

A note to applicants from Shelly:  

Hello, so glad you are here!  Thanks for taking this courageous step to 1) consider participation in this workshop and 2) ask for support in being able to do so!  These first steps are often the hardest ones.  So, good work on landing here, and keep it up!  

I want to assure you that all answers to this will be held confidentially - as a member of the International Coach Federation, I am bound to the Coaching Code of Ethics.  A key component to that is confidentiality.  In addition to that, be assured that I will hold your answers to these questions with great care and reverence.  As someone who has benefited greatly from work with spiritual directors, therapists, coaches, doctors, nurse practitioners, physical therapists, good friends, and a loving spouse (whew, it really takes a team), I am acutely aware of how a trusting relationship plays a key role in establishing a meaningful relationship of care.  

If you would prefer having a conversation about your interest/request,  rather than commit to filling out this form (or putting your answers on a google form), please do reach out to me at 414-238-3205 or email me at shelly@shellyroder.com.

Last note: Time is so valuable - based on my own "testing", this form should take only 15-20 minutes to complete.  Please spend as much time as you need on it, but know that short, simple, and straightforward works for me.  I know you likely have many other things on your plate, so please don't let this application keep you from those priorities!  My mantra: done is better than perfect.  :)  

Peace and all good!  
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Email *
Name (first, last, what you prefer to be called) *
Phone number *
How did you hear about the workshop? *
How could a coaching workshop most benefit you at this time in your life? *
What would you hope to receive from a coaching workshop? *
What challenges are you facing currently? Or - what areas in your life are you most interested in cultivating change/transformation? *
Where do you find support for those challenges? *
Please mark all that apply
What other ways have you sought support for growth, learning or transformation in your life? *
Of the ways you receive support, what has been most helpful or transformational? *
Of the ways you receive support, what has left you feeling disappointed, discouraged or otherwise feeling a need for more? *
How would receiving this workshop as a gift through scholarship affect your life? *
Would you be willing to have a half hour conversation with me about this workshop and your request? *
If so, which time frame is the best time in which to reach you for a half hour conversation between January 23 - January 29? *
Anything else you'd like me to know?   *
That's it!  Now all that's left is a message from me to you:
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