Referral and General Interest Form

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Thank you for your interest. This form is a beginning of sharing and learning about healing gatherings with Our Fire Collective. Personal information you provide will be used to determine the best fit for an invitation to participate in a gathering designed to meet specific needs of participants, and will be kept private to the facilitators, administrators, and with logistics lead people, for certain information once placed in a group. We aim to set up containers that will be safe for growth and collective work that will challenge us to create sustainable change.

If you prefer a phone call to begin the process, go to our website to schedule one, email ourfirecollective@gmail.com, or voicemail/text to 617-286-2596.

The average time to complete is around 4 minutes to refer someone and/or 12 minutes to complete all questions for yourself.

Thank you for taking the time

Email *

First Name *

Last Name *

Phone Number *

Your preferred gender pronouns

I am completing this on behalf of *

Myself: I am an educator interested in participating

Someone else: I would like to refer to participate (more about them next)

Both for myself and to refer someone else (we'll start with your info)

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