WWCo. General Retreats Application -

WWCo. Retreats Application
Personal Information
Full Name*

First NameLast Name
Date of Birth

MonthDayYear
Date
Mailing Address*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Preferred Method of Contact*
Church Information
Do you attend church*
Denomination*
Church Address*
Senior Pastor's Name*
Your Role in Church if any other than an attendee.*
Do you know/ understand your spiritual gifts?*
Emergency Contact Information
Full Name*

First NameLast Name
Relationship to You*
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Retreat Expectations
What are your main reasons for wanting to attend this retreat with Juliette? (Please check all that apply) There are no wrong answers.*

Spiritual RenewalFellowship and quality time with Juliette RossBuilding RelationshipsTruly Needing a confidantRest and RelaxationLearning and DevelopmentCounseling and SupportOther (please specify)
What topics or issues would you like to see addressed during the retreat? (Please list)*
Do you have any specific goals you hope to achieve by attending this retreat? *
Personal Information
Status*
Any Children*
Are your parents still with us?*
What is/was your relationship like with your parents?*
Do you have any siblings? If so, how many*
If yes, are you the oldest, youngest, or somewhere in the middle
Briefly Describe your childhood.*
Describe your current season of life and ministry. *
How do you currently nurture your spiritual growth?*
What support systems do you have in place (family, friends, church community, etc.)? *
Do you feel like you are a self aware person?*
Are you teachable?*
Do you easily take offense when receiving corrective criticism*

YesNoSometimes if I am being honest.Depends on how it is delivered to me.
Do you trust easily or more heavily guarded?*
Are you open to building new, safe relationships from this retreat?*
Do you find yourself to be a more critical person? Do you often find yourself pointing out the negative or complaining? If so, are you honest enough to yourself to admit why?*
Do you have a person you can trust and talk to?*
Work Life
What is your current profession and how long have you been in this position.*
Are you happy on your job?*
Have you ever had significant disciplinary/ performance issues at work?*
Do you have issues working with others?*
Do people have issues working with you? *
Do you have any professional goals other than what you do now? What are they?*
Education
What is the highest level of Education you have received?*
Do you have any further educational goals?*
If you could go back to school now at this stage of your life, what would you major/minor in?*
Would you change anything from previous educational interests?*
Fun Stuff

Hobbies & Interests
Do you have any hobbies/ interests/ activities? *
What are some of your favorite things to do in your downtime?*
Describe a perfect weekend.*
Favorite snacks*
Favorite Color?*
If you were to receive a gift basket.. what inside would make you smile and your heart happy?*
List a few of your favorite things.*
Favorite Scents (if any)*
Favorite genre of music and/or favorite artist?*
If you could do 1 thing that personally fulfills YOUR own personal heart’s desire, what would that be?*
Do you have a favorite scripture?*
Are there any specific activities you would be particularly interested in? *
Do you have any fears or phobias?*
Are there any specific activities/ animals that you are deathly afraid of?*
Do you have any expectations or desires you would like to have /happen at the end of this retreat? Please explain.*
Are you an introvert, extrovert, or ambivert?*
Health and Dietary Information
Do you have any dietary restrictions, food allergies or any sensitivities?*
Do you have any medical conditions or health concerns we should be aware of? Have you been diagnosed with any mental health disorders? *
Are you currently taking any prescription medications? *
Do you require any special accommodations during the retreat? *
Pricing
Our retreats are all-inclusive with lodging, food, land transportation, activites & any take home gifts, (+) Includes a 1 Year subscription plan to Mentor U! to further your in person community and discpleship with Juliette Ross and the rest of the mentors on the platform.

These retreats are for 3 nights stay. We do offer payment plans for your convenience. Please inquire within at retreats@wholewomanco.org for any other questions. It does NOT include your air travel.

Pricing for our all-inclusive WWC reatreat are as follows and can vary on time of year and location.

Dates: Galentines Weekend Retreat: Feb 6-9. $2750 - $3000

$2750 - Shared rooms. single beds &/or bunk beds (First come first served on single rooms (if avail)

$3000 - Single rooms (not shared with anyone)- first come first served. (Bathrooms are shared).

* MentorU! Plan starts at time of your completed registration.
Logistical Information

Travel
Will you need transportation assistance to and from the retreat location?*
Any additional Comments or Questions
Consent and Agreement
I understand that the information provided in this application will be used solely for the purpose of the retreat and will be kept completely confidential.*

YesNo
I agree to participate fully in the retreat activities and respect the guidelines and rules set forth by the organizers.*

YesNo
I consent and fully agree to keep all conversations, discussions that I engage in, hear, or are apart of in this retreat confidential and safe place for myself and others. I will not record or take any pictures without consent and/or without approved permission. I will keep other attendees personal information that may be shared completely private and not share it in any means. I agree to hold all things safe as other attendees will do for me. If you cannot honestly say that you can keep private information confidential, then please know this retreat may not be for you. Please answer honestly and respectfully. Thank You.*

YesNo
I am so grateful to host you at our Whole Woman Co. Retreat. I pray this experience leaves you refreshed, rejuvenated, loved and celebrated. I can't wait to meet you!
Please verify that you are human*
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WWCo. Retreats Application

Personal Information

Church Information

Emergency Contact Information

Retreat Expectations

Personal Information

Work Life

Education

Fun Stuff

Health and Dietary Information

Pricing

Logistical Information

Consent and Agreement

I am so grateful to host you at our Whole Woman Co. Retreat. I pray this experience leaves you refreshed, rejuvenated, loved and celebrated. I can't wait to meet you!