Personal Information
Your Full Name (First Name, Last Name)
Your Age
Your Phone Number (Best contact number)
Your Email Address
Your Address (Street, City, State, ZIP Code)
City
State
ZIP Code
What skills do you have that could support our nonprofit? (Check all that apply)
Sewing/Clothing Repair Carpentry/Woodworking Metalworking/Welding Pottery/Ceramics Grant Writing/Fundraising Marketing/Social Media Business Development Construction/Building (e.g., bathrooms, outdoor kitchens) Cooking/Food Preparation Gardening/Sustainable Farming Teaching/Mentoring Other
If you selected 'Other,' please specify:
Tell us more about your experience in the skills you checked above:
Eligibility & Readiness
We appreciate your openness and honesty in providing this information.
How committed are you to engaging in deep self-reflection and personal work during this retreat?
Do you have any physical limitations or accommodations we should be aware of?
Are you able to commit to the full 30 day experience? Yes No
Do you have any health or medical conditions we should be aware of?
Do you currently use any of the following substances? (Please check all that apply and provide details as needed.) Alcohol
Tobacco/Nicotine
Cannabis/Marijuana
Prescription medications (e.g., for anxiety, depression, pain, etc.)
Non-prescription or recreational drugs (e.g., cocaine, psychedelics, etc.)
Other
If you are using any of the substances listed above, please provide additional details: Type of substance:
If applicable, are you currently in treatment or recovery for substance use? Yes No Not Applicable
Do you anticipate being able to refrain from using substances during the retreat? Yes No Unsure
If you are actively using substances that might interfere with your participation or safety during the stay at Soulfull Waters, we recommend that you consider postponing your attendance until you are able to fully engage in the program.
Additional Information
Additional Comments or Questions:
Agreement & Consent
By submitting this application, I consent to the collection and use of my personal information for the purpose of reviewing my application.
Signature*
Only participants over the age of 18 can participate.
Date:
After you submit the application you will be notified by one of our team members regarding application approval and further details. Thank you.
