Private Staged Reading, Workshop & Dinner: an on your feet foundation mini-retreat
Register today to attend a day of story-sharing, support, connection and discovery designed just for you, a birthmother! This is a registration form for the PRIVATE STAGED READING, WORKSHOP & DINNER happening at Piven Theatre, in Evanston IL on November 17th, from 1pm-7pm.
Email address *
Full Name (Last, First) *
Phone Number (Area Code/Number) *
Street Address (Apt/Unit) *
Street Address line 2
City, State, Zip *
Date of Birth *
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DD
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YYYY
Have you attended any past OYFF events? *
If you have attended an OYFF event, what event(s) have you attended?
Type of Adoption *
Is the placement open, closed, semi-open? *
Name(s)/DOB children placed *
Date of placement(s) *
Do you feel the placement was your choice? *
Are you parenting? *
If you are currently parenting other children, please list the name(s) and age(s) of your child(ren):
What, if anything, made you decide to attend this special event? *
What do you hope to get out of this day? *
Please explain what kind of a support system do you have (ex. counseling, friends, family, other birthmothers, etc.). *
I am interested in: (please check all that apply)
Please list anything else you would like us to know about yourself, or anything we should know before joining us on this special day.
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