check

Women Emerge Interest Assessment

Thank you for your interest in Women Emerge!

This brief assessment will help us understand what you’re looking for in our workshop or retreat experience, and ensure it aligns with your goals. Please answer a few questions so we can learn more about you and how Women Emerge can support your next steps.

Click the button below to start.

Start

Question 1 of 12

Please provide your contact details so we can reach you about your application:

Question 2 of 12

Full Name

Question 3 of 12

Email Address

Question 4 of 12

Phone Number

Question 5 of 12

What state do you live in?

Question 6 of 12

Are you interested in attending the Women Emerge Workshop or Retreat?

(Select all that apply)
A

Workshop (Tampa, Florida January 23-24, 2025)

B

Workshop (Alanta, Georgia September 24,25, 2025)

C

Retreat (Tampa, Florida March 28-30, 2025)

D

Retreat (Atlanta, Georgia April 25-27, 2025)

Question 7 of 12

What interests you most about the Women Emerge Workshop or Retreat?

(Select all that apply)
A

Personal growth and self-discovery

B

Gaining clarity on my goals and next steps

C

Building confidence and making bold decisions

D

Connecting with like-minded women

Question 8 of 12

What are you hoping to achieve by attending Women Emerge?

(Select all that apply)
A

Defining a clear vision for my life/career

B

Building confidence to make bold decisions

C

Finding purpose and direction

D

Developing a personal action plan

Question 9 of 12

How would you describe your current life stage?

A

Early career, exploring possibilities

B

Mid-career, seeking clarity and direction

C

Experienced professional, ready for the next chapter

Question 10 of 12

What age group do you belong to?

A

18-24

B

25-34

C

35-44

D

45-54

E

55+

Question 11 of 12

Are you comfortable sharing within a group?

(Select all that apply)
A

Yes

B

No

C

Somewhat

Question 12 of 12

Tell us a little bit about yourself and why you believe that Women Emerge is a good fit for you? (Include anything else you would like for us to know.)

Confirm and Submit