Self-Designed Life - Course Enrollment

The Self-Designed Life is a 14-week Workshop course developed by Survivors with the guidance of clinical perspectives and expertise. This course combines mental and emotional tools with practical steps into a trauma-informed restorative program. The purpose of Self-Designed Life is to create a peer-to-peer community, a safe space to process, rebuild, and heal on your own terms.

Through course work, hands-on activities, group discussions and combining practical steps with mental and emotional tools, you will learn about trauma and its effects, coping and self-care tools, tools for planning and goals, resources to support pursuing educational and professional goals, and much more.

Each weekly 90-min session of this course has a specific focus and includes exclusive practical tools, checklists, trauma-informed care, resources and other bonus items like journal prompts, mindfulness, self-care practices, and much more.

These courses are generously sponsored by i-5 Freedom Network's partners, supporters and donors, and are therefore offered to participants as a scholarship. The courses are open to Survivors of human trafficking, domestic violence, cult upbringing and other forms of exploitation.

If you are interested in taking the SDL course, and are able to commit to being on time and present for each session, please fill out this enrollment form. Your responses will be kept confidential.

Reach out if you have any questions at all! We look forward to hearing from you! sdl@i5freedomnetwork.org

First name

Last name

Nickname/Preferred Name:

Phone

What is your mailing address? (For Sunshine Box)

What pronouns do you prefer?

She/Her

He/Him

They/Them

Other

Name of person or Organization that referred you (referring yourself counts!) :

Contact information of person or Organization that referred you, if applicable. (Email or Phone Number):

I am a (check all that apply):

Tell us a bit about yourself

Respond in the way you feel comfortable, being as honest and authentic as possible. There isn't a requirement to respond, however all responses will be kept confidential.

What are some of the reasons you'd like to participate in the Self-Designed Life course?

Do you personally identify as "Survivor" or do you prefer another designation/ description?

After hearing about the Self Designed Life course, what areas in your life do you hope it might help or improve?

What would be some ways we could support you while participating in the SDL course? For example, tech support, communication, time management, etc.

Commitment to Participate

To make sure you can get the most out of this course, and also to respect the other participants, it's required that participants be on time and be present for every session.

The questions below will help to identify challenges or issues that could affect full participation, and so we can see the best way to support you for success in this course.

Do you have access to your own computer or laptop? (We will, when available, provide access to a laptop for the duration of the course if needed.)

Do you have a quiet and private place to join the courses? This is both for yourself and for the sake of the other participants.

Yes

Not sure

Other

Are you able to help us by completing 2 confidential surveys - an Exit Survey after the program has ended, and a One Month Follow-up?

Yes

Not Sure

Other

We believe in you and know your time is important. By checking the boxes below, you are showing your intention to be on time, attend every session, and participate in the best way you can, or how you feel safest. (Choose all that are appropriate).

I will be on time

I will attend every session

I will be present and participate in the best way I can

I won't be able to commit right now, please add me to the contact list for upcoming courses

Other

What challenges might prevent you or hinder you from participating in this course?

I have young children in my care who may be with me at this time

I will be working full time and it could affect my participation or being on time

My schedule is unpredictable

I don't foresee any challenges that might interfere with my participation

Other

Do you have any additional questions for us?

Thanks for submitting your enrollment form. Let us know if there is any you need to prepare for this course. We are here to support you in your journey.

APPLY TO BE IN
OUR NEXT COHORT

Self-Designed Life - Course Enrollment

Tell us a bit about yourself

Commitment to Participate

APPLY TO BE IN OUR NEXT COHORT

APPLY TO BE IN
OUR NEXT COHORT