Please read the course information on the Home and 8-Week Course pages before submitting this form. If you have any questions, please get in touch via the Contact page. (There are links on both the Course and Contact pages that will bring you back here when you're ready.) Thank you.
Please note: This information will be seen only by the course instructor, in complete confidence. If you feel uncomfortable answering any of the questions, you can simply note that on the form; we can have a private conversation before the program begins if that would be helpful. Leaving a question blank will have no impact on inclusion in the program.