Expression Alchemy Retreat Program Application

Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number*

Area CodePhone Number

E-mail*

Facebook address:

How did you hear about this retreat? *

What inspires you to apply for this retreat? *

What feels most important right now?*

What do you feel when you think of the word and act of EXPRESSION?

What would you say are your current challenges, setbacks, fear, blocks, and/or limitations? *

What would the impact in your life be if you were to solve these? *

Why do you believe these blocks, challenges, setbacks, fear, doubt etc are still present in your life? *

What are you greatest gifts and strengths? *

What gifts or strengths do you want to lean into more? *

If you could gain anything from this retreat, what would it be? *

Describe yourself as a metaphor or a symbol. *

This weekend is a sacred energetic container for the evolution of each woman that attends. The value of coming together in a group is extraordinary when everyone is there to play full out and support each other in the highest integrity and appreciation for one another.

Each woman who attends is asked to participate fully in non-judgement and hold space for every woman's emergence and unfolding.

Expression involves a high level of vulnerability and requires the feeling of safety in order for a woman to surrender and open into the space.

The next block of questions is to ensure that you are able and willing to hold space for yourself and others in the group in openness, encouragement and celebration of one another as you participate in this journey.

Have you ever been diagnosed with a mental or emotional condition or are taking psychiatric medications? *

Have you ever participated in a retreat? Have you ever been coached? *

How much experience do you have doing spiritual work/personal development? Please share what you have experienced and the kind of work you have done.*

Are you able and willing to support a space of non-judgment and encouragement? *

What matters most to you in a coach or mentor? *

What matters most to you in a group setting? *

Are you looking for a single event/program or for possible longer term support? *

Thank you for your application!

I will review and respond back to you within 48-36 hours. I look forward to possibly connecting and seeing you soon!

With gratitude,

Monica

Retreat Questionnaire

Expression Alchemy Retreat Program Application

Thank you for your application!