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Sign up for We-Care

This is the online registration form for We-Care: Collective Compassion Practices for Creating Thriving Teams and Communities. If you have any trouble completing this form online, feel free to contact us and we can register you by email or over the phone.

"*" indicates required fields

Name*

First Last

Email*

Where do you live on the planet?

State / Province / Region Country

What is your time zone?*

Which meeting time for the live modules would you like to attend?*

Generally speaking, when would you be available for the weekly one hour small group practice sessions (check all that apply)?

As part of the course, you will be in a cohort group where, each week, you will meet to practice the collective practices introduced during the live sessions.

Weekday early mornings before 8am

Weekday mornings between 8am and noon

Weekday afternoons before 5pm

Weekday evenings between 5pm and 8pm

Weeknights after 8pm

Weekend early mornings before 8am

Weekend mornings between 8am and noon

Weekend afternoons before 5pm

Weekend evenings between 5pm and 8pm

Weekend nights after 8pm

Are you willing for us to share your email address with other course participants to support ease in scheduling the small group practice sessions?*

Yes, I’m willing for you to share my email address with other course participants for the purpose of small group scheduling.

No, I’m not willing for you to share my email address with other course participants.

Are you joining this course as part of a group, organization, or community?*

What is the name of your group, organization, or community?*

Are there 5 or more participants joining this course from your group, organization, or community?*

(a 67% discount is offered to participants from groups of 5 or more joining from one group, organization, or community)

We-Care (full 5-module course with all materials included))*

Price:

We-Care (group rate for full 5-module course with all materials included))*

Price:

Discount Code

What form of payment would you like to use?*

Credit Card/ Paypal processing fee

$0.00

Total (USD)

Credit Card*

Card Details

Cardholder Name

Billing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Paypal Payment Method*

American Express

Discover

MasterCard

Visa

Supported Credit Cards: American Express, Discover, MasterCard, Visa

Card Number Expiration Date Security Code Cardholder Name

Are there any particular questions or topics you'd like to explore in the course?

Do you have any other requests for Jesse, the facilitator?

Comments

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