Please send this information by email to Judy@couragerenewal.org
Registration/Application for
Connection Not Critique – A Writing Together Online Retreat Series
Your Name ___________________________________
Your e mail ___________________________________
Address (includes mailing address, city, state (if applicable), country
______________________________________
Would you like your name, city and state, and e mail address to be on a participant list?
Yes
No
Your phone number, to be sure we can reach you if necessary
_____________________________
Are you applying with a partner? Yes _____ No_______(if yes, list name and email, below. Partners should also fill out complete registration form)
Name of partner
email
Are you applying as an individual? Yes ______ (if so, retreat facilitators will pair individual applicants for the four retreats)
What attracts you to this retreat at this time?
____________________________________________________
Please state you intention to be present for all four Thursday sessions:
____________________________________________________