We are now accepting applications for our '24-'25 cohort. Applications are due no later than May 1 at 11:59 PM CST.
Membership Application
Hello and thank you for your interest in The Sanctuary Collective, a Marquisha&Co. extension. Please note that membership for this collective is limited to: (1) Women who reside in Nebraska. (2) Women who are interested in COLLECTIVELY building, healing, and working alongside other women. (3) Women who desire holistic improvement. Please reference the site: https://marquishaandco.com/the-sanctuary/ for more information before submitting this application. To be considered for membership, complete this application in its entirety. Direct all questions to hello@marquishaandco.com.
Name
*
First Name
Last Name
Birthdate:
*
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Month
-
Day
Year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
E-mail
*
example@example.com
Phone Number
*
Preferred method of contact:
*
Please Select
Phone Call
Text message
Email
Dietary Restrictions
If none, please type n/a
Allergies
If none, please type n/a
T-Shirt Size
*
S
M
L
XL
2X
3X
4X
Personal Website
Social Media:
*
Please include the platform & your handle (Ex: Twitter @__thedocisin)
Area of Expertise:
*
Please Select
Corporate
Business Development
DEI
Education
STEM
Academia
Wellness
IT
Healthcare
Real Estate
Financial Services
Entrepreneurship
Other
Primary area of focus you envision the Sanctuary Collective helping you with (please select all that apply):
Healing
Capacity Building
Relationship Building
Career Progress
Academic Support
Community
Parenting
Spiritual
Goal Digging
Other
Please share why you're interested in joining The Sanctuary Collective:
*
Please upload your resume or CV:
*
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References
Please include a reference that can speak to your ability to work collaboratively with other women and your willingness to learn and grow.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Membership in The Sanctuary Collective requires members to 1) Sign a non-disclosure agreement to protect confidentiality, 2) Pay dues of $65/month, and 3) a one-time joining fee of $150 that covers administrative costs and associated new member materials. Is this something you can agree to:
*
Yes
No
Signature
*
Signature Date
*
-
Month
-
Day
Year
Date
Print or Review Form
Apply for Membership
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