Mini-Fight Club for Military Spouses

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

This in an APPLICATION to apply for our Mini-Fight Club Group for military and veteran spouses. This will be a 1.5 hour virtual support group meeting to connect and discuss the close of the two-decade war on terrorism.

There will be two opportunities to connect. You can choose this Thursday 9/9 11:30 CST OR Friday 9/10 11:30 CST.

Fight Club exists to provide spouses a set aside time each week to consider their own self-care with the support of other spouses who understand. The group, made up a limited number of participants, is a safe place to process thoughts and emotions that come with the service lifestyle in complete confidence face-to face. Each week, the group processes a topic that relates to the service lifestyle and or a coping skill that is necessary for the uncertainty and inconsistency they face.If you are a military or first responder spouse, you are invited to join a truly transformative group of other spouses as you fight for yourself, each other, and your marriages. Together, you will find that the service lifestyle is much better when you do it with others beside you. Fight Club is an amazing experience of connection and support. It is important that all participants commit to ALL 10 weeks of group to fully experience it to the fullest (and create the bonds within the group). Therefore, participants agree to pay the one time payment of $140 in advance in order to create buy-in and help members fully commit to the Fight Club.

What is your name (First and Last)?

What is your location?

What is your age?

18 - 24 years old

25 - 34 years old

35 - 44 years old

45 -54 years old

Over 55

What is your gender?

Female

Male

Prefer not to say

Other:

What is your ethnicity?

White

Hispanic or Latino

Black or African American

Native American or American Indian

Asian/Pacific Islander

Other

Prefer not to disclose

What is your highest degree or level of school you have completed?

Less than a high school diploma

High school degree or equivalent

Bachelor's degree (e.g. BA, BS)

Master's degree (e.g. MA, MS, MEd)

Doctorate (e.g. PhD, EdD)

Other:

What is your current employment status?

Active Duty

Employed full-time (40+ hours week)

Employed part-time (less than 40 hours a week)

Unemployed (not currently for work)

Student

Retired

Self-employed

Unable to work

Do you have a serving spouse that is TDY or deployed? (Note: this is not a disqualifier for group).

Yes

Clear selection

Group will be held virtually using Google Hangouts Meet that you can access from your mobile device (data) or desktop. Do you have decent quality wifi or internet connection available for use?

Yes

Maybe

Clear selection

Have you ever been in an psychoeducational or counseling group (Spouse Group)? Was it helpful? Why or why not?

How would you like to benefit from this group?

What topics would you like to see discussed?

Do you foresee any issues that would keep you from attending all 10weeks? (Every Monday night other than Holidays)

Do you agree to respect the opinions, beliefs and or view points of others in this group?

Yes

Maybe

Other

Clear selection

Do you agree to keep conversations from the group confidential outside of group? (maintain confidentiality of all group members?)

Yes

Other:

Clear selection

Do you agree to contribute to developing and upholding the ground rules of the group?

Yes

Maybe

Other:

Clear selection

Is there anything else you would like us to know about you?

If we are unable to bring you into this Winter group due to space, would you be interested in being notified about the next group we open up?

Yes

Clear selection

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Corie Weathers - Lifegiver.

Does this form look suspicious? Report

Forms