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This application helps us to get to know you a little bit better and coordinate our facilitation with your Loveship specifically in mind.

1- Read Loveship Page

2- Registration Application

3- Payment Arrangements

4- Receive confirmation email.

DONE!

! ATTEND !

Loveship

COHORT Registration Application

CONTACT INFORMATION

Name 1

Enter name and contact info for one of you in the Loveship.

First Name

Last Name

Email 1

Phone 1

(###)

###

####

Snail Mail Address 1

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name 2

First Name

Last Name

Email 2

Phone 2

WHO WE ARE

We self-dentify as being part of the:

Let us know how you identify. If what we have doesn't fit please choose "other" share your response in the area below.

Other:

We both identify as:

Other

We are available to participate in the Opening and Closing Webinars as well as all the practice sessions.

WE agree to attend and fully participate in all of the following: 1. The Opening Webinar (Jan 10th 4-7pm Eastern Time) 2. A one hour session with Alexis and Sangodare between Jan 11-13th (to be scheduled with each Loveship) 3. (4) Sessions with another Loveship between January 13 and Feb 7 (to be scheduled with your peer support Loveship at a time that works for all four participants) 4. The Closing Ceremony (Feb 9th 4-7pm eastern)

We are in a committed partnership. (We have decided to be in partnership for the long term and we are not currently in a process of deciding WHETHER to be in partnership):

If this cohort is full, please add us to the next cohort.

Yes

Our vision for participation in the Loveship Cohort is:

Our previous experiences with couple/loveship support and community include:

We consider the gifts our Loveship offers to the world to be:

Once you click “APPLY” you’ll go to a payment arrangements page.

Note: You are not registered until you receive a confirmation email from us. If the cohort is full you will be refunded.