Brave Sister — Steady During the Storm: 12-Week Online Group Interest Form
Please complete this interest form using the exact wording provided. The form description should include the introductory paragraphs about the group and confidentiality, and the Thank You page should show the exact closing message with Redemptive Journey contact info.
Contact Information
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
What is the best way to contact you?
*
Email
Phone call
Text message
What time zone are you in?
*
Group Interest
Are you interested in joining Brave Sister — Steady During the Storm?
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Yes, I am interested
I would like more information first
I am not sure yet
Does Tuesdays from 7:00–8:30 PM CT work for you?
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Yes
No
I am not sure yet
Are you able to commit to attending weekly as much as possible for the 12-week group?
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Yes
No
I need more information
Does the group investment of $80/month plus a one-time $25 workbook purchase feel manageable for you at this time?
*
Yes
I may need to discuss payment options
No, not at this time
Your Story
What led you to reach out about this group?
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Have you been impacted by a partner’s addiction, infidelity, deception, or destructive sexual behaviors?
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Yes
I believe so
I am not sure
I would rather discuss this privately
What kind of support are you hoping to receive from this group?
A safe place to be honest
Support from women who understand
Faith-based encouragement
Practical tools for steadiness
Help understanding betrayal trauma
Space to reflect and process
Clarity for next steps
Other
Is there anything important you would like us to know before we follow up with you?
Safety and Support
Are you currently in crisis or feeling unsafe?
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No
Yes
I am not sure
If you answered yes or you are not sure, please briefly share what kind of support you need right now.
Do you currently have a counselor, therapist, coach, pastor, or support person walking with you?
Yes
No
I am looking for support
I would rather not say
Confidentiality and Next Steps
I understand that Brave Sister is a support group and not a replacement for professional counseling, therapy, legal advice, or emergency services.
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I understand
I understand that completing this form adds me to the interest/waitlist and does not guarantee placement in the next group.
*
I understand
I understand that Redemptive Journey will contact me with next steps.
*
I understand
Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit Interest Form
Submit Interest Form
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