Participant Application


Get Started

We are so excited that you are interested in becoming a participant for the Women’s Empowerment Series! Please fill out the forms below to get started. 

You are required to interview to be considered for the program. A committee member will reach out to all applicants regarding acceptance into the Series or ongoing involvement. 


Participant Application

Any information shared with our organization is strictly confidential and will be used only to help you move forward to healing, health and happiness! 


Emergency Contact & Medical Release

This form gives us the contact information for your Emergency Contact – A person we would contact in the rare case of an emergency. 


Youth Empowerment Series

If you are interested in having your child be involved in the Youth Empowerment Series, our team will be in contact with you to find out more information.


“I learned so many valuable and useful tools –– and have overcome a very crippling addiction, got the courage to go through with a divorce and lost the barriers that were holding me back – self-pity, self-centeredness, and depression. I am a MUCH better woman now and I CAN conquer ANYTHING. I turned the bad in my life into a positive and my mission is to happily help others overcome theirs!” – Ali S. | Graduate