North American Boarding School Survivors Workshop.

HOW IT WORKS:

Interested?
Let us know:

*The information you provide in this form is strictly confidential.

*Due to the limited number of spots available, please only fill out this form if you have a sincere interest in attending the Workshop and have reviewed the detailed flyer and cost.

Fill out ALL sections of the information form below.

After you’ve submitted the below form, we’ll be in contact with you to either confirm your acceptance to the Workshop or to ask additional information.
Once you confirm your attendance to the Workshop, we will be back in touch with logistical information.

Name

First Name

Last Name

Phone

Country

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Birth

YYYY

Occupation, Job or Profession

If you have previous experiences of personal development work, please give brief details

Current psychotherapist’s or counsellor’s name, if applicable

Brief details of any psychiatric history, if applicable

Doctor’s or physician’s name and contact, if currently under treatment

Where were you born, and where did you grow up prior to boarding? What was broadly positive for you about your home and family of origin, and what was broadly negative?

At what age were you first sent to boarding school? In what country was your boarding school?

To the best of your recollection, what kind of child were you before being sent away, and what kind of child were you when you were in the boarding school?

What is your current relationship status? If you have children, how many, and what are their ages?

What are the current issues and challenges you need to address or face up to? You might want to include something brief about your personal life, your relationships, your relationship to alcohol and other substances.

Briefly, describe how you see yourself, your emotional life, your reactions to stress or conflict, and especially areas where you feel habitual reactive patterns may have been formed at boarding school which cause you difficulties.

Why at this particular point in time do you want to do this workshop? What are your hopes and fears about attending it? Please go into some detail in this part, so that we have a relatively full picture of your wishes and needs.

How did you hear about this workshop?

North American Boarding School Survivors Workshop.

HOW IT WORKS:

Interested? Let us know:

Interested?
Let us know: