Reclaiming Ourselves Circles: Interest and Availabilities Form

Reclaiming Ourselves - Women's Circles and Retreat - Interest and Availabilities
See info on the current Winter-Spring 2015 Reclaiming Ourselves program here:
* Required
Name (Full if possible so I can get back to you) *
Your answer
Email Address (so I can get back to you if you requested it) *
Note: I will never sell nor share your emails to another party. I also won't sign you up to my mailing list without your consent. If you do so desire, indicate your choice below.
Your answer
In which format are you most interested?
Select all that applies
For the Retreat(s), what is your preference
Select All that Apply
For any of the Series
Select All that Apply
For Weekdays Series
please select all that apply for you
Please provide any additional comments or your preference
Note that I can't accommodate all requests but will try my very best to hold your information in the planning of future events
Your answer
If you would like a short connection to see if this program would best meet your needs Please provide your telephone number or email address below
Your answer
Do you want me to add you to Core To Coeur / Peace Circle Center mailing list?
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