RISE Registration Form

RISE Registration (Resilience In Shared Experience)
The next 8-Week RISE (Resilience In Shared Experience) Sexual Violence Survivor Support Group series will be held virtually (via Zoom) on TUESDAYS, January 13th - March 3rd, 2026 6:00pm -7:00pm.(To protect and maintain your privacy, registered participants will receive a new Zoom meeting invitation link via e-mail each week of the series.)
*Personal identifying information will not be shared.
Preferred Name*
Age *
E-mail *
example@example.com
Race*
Gender*
Pronouns
City*
How did you hear about us?*
Group Acknowledgement*

By checking this box, I acknowledge that this is a Psycho-Educational Group which focuses on education and support. This is not a therapeutic group.
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RISE Registration (Resilience In Shared Experience)