Gold Membership Application
The gold membership is extremely limited - with applicants so far from 6 countries! Eileen and I will screen potential applicants and are accepting a maximum of 15 people from around the world. We are taking applications until our launch date September 14, 2022. We will accept those who represent a group of generational, racial, geographical and other diverse identities. We are also looking for those who are committing to this path and have some experience facilitating groups in a variety of settings. We are asking for those who want to seriously “up their game” and will commit to supporting their peers in this group for one year!
Name *
Email *
Current Country/region/state of Residence *
What time zone are you in (e.g., Pacific Standard, Central European, Central East African, etc.)? *
Your Generation *
Your Ethnicities/Race *
Other identities you are willing to share.
Your experience with facilitation, e.g. types of clients sectors served whether you are in-house external years of practice types of methods you are currently using. *
Your willingness to commit to a year long program and attend > 80% of the sessions *
Anything else you would like to say about why you like to attend this program.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms