Short-term stay at the Fireplace Community
Thank you for your interest in visiting the Fireplace Community! Please be aware that submitting this form does not guarantee that we will be able to accommodate your request. We will contact you to confirm whether or not we are able to host you. Please allow 1-2 weeks for confirmation. You may also contact thefireplacecommunity@gmail.com with any questions. 

Short-term guests may stay at the Fireplace for up to two weeks. People interested in a longer stay at the Fireplace must complete our full resident application process. 
Sign in to Google to save your progress. Learn more
Email *
Visitor name(s) *
Pronouns
Phone # *
Mailing address
Requested dates, plus time of arrival/departure, if known. If you have multiple date options, please indicate them here. *
How did you hear about the Fireplace Community? *
Why are you interested in visiting the Fireplace Community? *
Please sign your initials to confirm that you have read the Visit page on the Fireplace website to learn about our house and accessibility.  *
Please share any dietary needs, allergies, or accessibility needs that the Fireplace should know about. 
Anything else we should know, or any questions for us?
Would you like to receive our email newsletter with information about upcoming events and programming? *
Do you identify as an artist, activist/organizer, and/or spiritual seeker? 
Check all that apply. This question helps us understand the people who visit our community. You are not required to identify with these categories.
Are you coming to the Fireplace for a Religious Renewal Residency?  *
This 2023-24 offering is for clergy in any denomination/tradition, vowed religious, affiliates/associates of religious congregations, and lay religious leaders. It is supported by a grant from the Leadership Conference of Women Religious. Click here to learn more.
Next
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