• Emerge2Empress Intake Form / The Empress Collective Membership Request

    Thank you for your interest in The Empress Collective, the private, invitation-only women’s empowerment space. This intake form helps us understand where you are, what you are seeking, and whether The Empress Collective is the right fit for you.

  • Personal Information

  • Format: (000) 000-0000.
  • Preferred Method of Contact

  • Invitation & Connection

  • Current Season & Needs

  • Which statement best describes your current season?
  • What areas do you need the most support in right now?
  • Which area feels the most urgent for you right now?

  • Readiness & Alignment

  • Community Agreements

  • Do you understand that what is shared in The E2E Sanctuary stays in The E2E Sanctuary?*
  • Do you agree not to repeat another woman’s personal story, struggle, identity, or private information outside this space?*
  • Do you agree not to gossip, shame, judge, mock, or tear down another woman in the space?*
  • Do you agree to speak from your own experience using “I” statements when possible?*
  • Do you understand that members may offer encouragement and suggestions, but no one is expected to fix your life for you?*
  • Do you agree to honor the weekly topic and not pull the group away from the purpose of the session?*
  • Do you understand that disruptive, disrespectful, unsafe, or harmful behavior may result in removal from the space?*
  • Please confirm the following agreements*
  • Do you agree that invitation-only participation is required for this space?*
  • Do you agree to maintain privacy and confidentiality regarding all personal share-outs in this community?*
  • Do you agree to participate in a respectful, supportive manner?*
  • Do you agree not to gossip, compete with others, or tear down another woman?*
  • Do you agree to communicate with honesty, kindness, wisdom, and respect?*
  • Do you understand this space is for empowerment and is not therapy, medical care, or emergency support?*
  • Do you understand that disruptive, unsafe, or harmful behavior may result in removal from the space?*
  • Do you understand that workshop registration and payment notices may apply to some offerings?*
  • Are you willing to grow, listen, reflect, and become the woman you are called to be?*
  • Do you give permission for live sessions to be recorded for personal replay if you are accepted and unable to attend?*

  • Spiritual & Support Fit

  • Are you currently receiving support from a therapist, counselor, pastor, mentor, medical provider, or other professional?
  • Are there any topics that may be sensitive or triggering for you in a group setting?
  • Are you currently in immediate danger, crisis, or at risk of harming yourself or someone else?*
  • Do you understand that E2E is an empowerment community and not a crisis-response service?*
  • Are you comfortable with spiritual encouragement being included in the space?*
  • Are you comfortable with this being a ministry based group?*

  • Scheduling & Participation

  • How do you prefer to receive guidance? Select all that apply.
  • Can you commit to attending when your schedule allows?*
  • Do you prefer sessions to be:
  • Would you be interested in paid E2E Empowerment Workshops in the future?
  • Which paid workshop topics would interest you most? Select all that apply.

  • Future Interest & Reflection

  • Agreement & Signature

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • Date Reviewed
     - -
    2 digit month, 2 digit day, 4 digit year
  • Recommended Starting Point
  • Should be Empty: