Deep Roots Circle Registration
Thank you for your interest in Deep Roots!  

This intake form is to gather basic contact information and a sense of where you are on your personal/spiritual journey. Your input will help to shape the focus and activities of this Circle.

Thank you so much for sharing your experiences and thoughts. And rest assured, your responses are confidential and will not be shared with anyone. I look forward to getting to know you!

With love and great-fullness,
Andrea

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Full Name *
Email Address *
Best Phone number to reach you - mark as Cell, Home, Work *
Why are you interested in the Deep Roots experience? *
Share briefly about your childhood and young adult religious/spiritual experience:
Share briefly about your spiritual journey in more recent years (shifts, focus, types of support, etc):
As of now, my level of experience with meditation is: *
Required
What spiritual practices are you interested in? (check all that apply and list others you think of) *
Required
Do you currently have a regular spiritual practice of some sort? If so, please describe?
Anything else you think might be important for me to know about you, your experiences and/or interests?
Which Taster Circle are you registering for?
How would you like to make your payment? *
Next Steps...
I will be in touch through the email address you have provided with more details and how to make your payment. Upon receipt of payment, you will receive details on the exact location and what to bring.

I am eager to deepen roots with you!

Much love and great-fullness,
Andrea
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