Virtual Circle Application Name* First Last Address* City State / Province / Region ZIP / Postal Code Phone*Email* Profession (or professional background if not currently working)*Website (if applicable) Where are you on your motherhood journey? Tell us a bit about your child/children...*What are you most on a quest for in your life right now?*We are committed to bringing together a diverse group of women for our circle. Please share a little about you. What are some of the social identities that you hold? (For example: race/ethnicity, gender, sexuality, disability, religion etc.) What shapes your identity? Share whatever is most comfortable to you.*What results would you like to get from the Circle? What would make you feel like this was a worthwhile investment?*What ideas do you have for a project/event/creation you might accomplish before the Circle is complete? (hint: think about what you’ve been “wanting” to do for some time now but always find a reason to put on the back burner)*Replays will be available but we ask that each participant try to attend every session live. Please check all dates that you are available. (All sessions PST) Thursday, November 7 12 - 2 PM Thursday, November 14 12 - 2 PM Thursday, November 21 12 - 2 PM Thursday, December 5 12 - 2 PM If none of these days/times work, please write the days/times that could be possible for you Yes I’m ready to invest in my E.P.I.C. Life NOTE: Before you click submit, please copy your responses to a word document and save as a back-up.