Rooted and Renewing Application Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Email * Where did you hear about Rooted and Renewing? * (e.g., friend, church, social media, therapist, website, etc.) Have you ever been a part of a group before? If yes, what kind of group was it? What was your experience? * (Examples: Bible study, 12-step group, therapy group, support group, etc.) Have you ever sought support from a counselor or therapist? * If yes, what aspects of that experience were helpful? Was there anything you found unhelpful? What are you hoping to gain from being a part of the Rooted and Renewing group? * Please share three gifts or strengths you bring to the group, and three challenges you are currently working to overcome. * Rooted and Renewing is a transformational journey—one of growing deep spiritual roots and experiencing ongoing renewal through the love and grace of Jesus Christ. Because of the personal and vulnerable nature of the work done in this group, a high level of commitment is required from each participant. Are you willing to commit to: 1) Weekly two-hour group sessions for three trimesters? 2) Completing outside homework assignments? Yes I'm not sure Which meeting time do you plan to attend? Monday evening at 5:45 p.m. Wednesday morning at 9:15 a.m. A brief Zoom interview is required before beginning the group. Are you open to meeting with us? Yes I'm not sure Total amount you will pay for this group: $1725 - paid upfront in full $1845 - three payments of $615, once per trimester $1920 - eight monthly payments of $240 I understand there is a $200 nonrefundable application fee (will be applied to the total cost) and a $30 materials fee. (to be paid after the Zoom interview) Yes We accept PayPal, Venmo, cash or check. How will you prefer to pay? * Thank you!
