Bloom Guide Application

Bloom Guide Application

Thank you for your interest in becoming a Bloom Guide. We are excited to learn more about you and your desire to help create safe, welcoming spaces where women feel seen, supported, and empowered to heal, grow, and bloom—estimated time to complete the application: 10-15 minutes. Please answer each question honestly. We are interested in learning about who you are-not finding perfect answers.
Personal Information
Full Name

First NameMiddle NameLast Name
Preferred Name
Pronouns
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Preferred Method of Contact
Emergency Contact
Emergency Contact Name

First NameMiddle NameLast Name
Relationship
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Getting to Know You
Why are you interested in becoming a Bloom Guide?
What does creating a safe and welcoming space mean to you?
What strengths would you bring to this role?
What qualities are important when supporting women?
Experience
Have you volunteered before?
Please describe your volunteer experience
Have you ever facilitated a group, workshop, class, or meeting?
Please describe your facilitation experience
Which areas have you worked with?

Other
Availability
Which days are you generally available?
Preferred times
Virtual Participation
Do you have reliable internet access for Zoom sessions?
Do you have a working camera for virtual participation?
Do you have a working microphone for virtual participation?
Do you have a quiet, private space for Bloom Circles?
Bloom Guide Commitment
Acknowledgment of Bloom Guide Expectations
Please review each expectation before continuing.
I understand these expectations apply if I am selected as a Bloom Guide.
Preferred communication method with Nest & Bloom staff
If you are unable to facilitate a Bloom Circle, how quickly will you notify the Executive Director?

Other
Applicant affirmation
References
Reference One Name

First NameMiddle NameLast Name
Reference One Relationship
Reference One Phone
Please enter a valid phone number.Format: (000) 000-0000.
Reference One Email
example@example.com
Reference Two Name

First NameMiddle NameLast Name
Reference Two Relationship
Reference Two Phone
Please enter a valid phone number.Format: (000) 000-0000.
Reference Two Email
example@example.com
Applicant Statement
Applicant statement
Applicant signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty:

Bloom Guide Application

Personal Information

Emergency Contact

Getting to Know You

Experience

Availability

Virtual Participation

Bloom Guide Commitment

References

Applicant Statement