Part 1: Contact Info
This is in case we need to get a hold of you during the program.
This is so we can mail you your Road Ahead welcome package.
Part 2: Demographic Info
MM slash DD slash YYYY
Part 3: Program Info
Road Ahead Cohorts during this 2023 quarter are as follows. For a list of cohort descriptions, see the top of the registration form or visit the Road Ahead page.
Type: All Professional
Guide: Nicole Dickens
Dates: Every Wednesday, starting 6/21/23 to 7/26/23
Times: 6:00–8:00 PM (Pacific)
Format: Online (via Zoom)
Guide: Terry Timm
Dates:Every Monday, starting 6/19/23 to 7/24/23
Times: 4:00–6:00 PM (Pacific)
Format:Online (via Zoom)
Type: Women Professionals
Guide: Kathy Young
Dates:Every Tuesday, starting 6/20/23 to 7/25/23
Times: 6:00–8:00 PM (Pacific)
Format:Online (via Zoom)
Please see above for each cohort's type, dates, and times.
Please include general days of the week and/or times of the day that work for you. You can also note that you're interested but want to wait until a future quarter.
Please select all that apply. This is in case we can't place you in the cohort you selected above. For a list of cohort descriptions, visit the Road Ahead page
Part 4: About You
In other words, why are you interested in joining? Why do you think the cohort can help you? What are your needs and pain points that you think this cohort can address?
Part 5: Everything Else
Remember: You have the option to add on individual coaching sessions that help you activate all that comes up in the group experience. Our coaches specialize in the Enneagram, CliftonStrengths, vocational discernment, and spiritual direction. We’ll customize our coaching to whatever best meets your needs! Cost is $300 extra.
You can say something like, "I want to learn more about the enneagram or CliftonStrengths," or "I need vocational discernment or spiritual direction." The more you tell us, the better we can serve you!
These scholarships are for the cohort costs. No scholarships are available for coaching at this time.
Please note: income level will not be used to determine scholarship amounts but are for future planning purposes.
In other words, how much scholarship, in dollars, would you like to request? Remember: Road Ahead cohort costs $500.
For instance, which cohort type is your first choice? Which upcoming quarter of the year are you most hoping to do Road Ahead? Really, the sky's the limit!
Please select all that apply.
Agreement Between You and the De Pree Center
Your submission of this form creates an agreement between you and the De Pree Center as to the following provisions, which take effect when you participate in a Road Ahead cohort:
1) Your participation in the cohort is a group experience, facilitated by an official Road Ahead guide who will partner with you a thought-provoking and creative process that inspires you to develop your God-given personal and professional potential.
2) With your fellow travelers and your guide, you agree to participate openly and honestly in group conversations, and to respect the confidentiality of everyone’s personal information discussed in the group.
3) Your individual conversations with your De Pree Center guide/coach will be kept confidential. However, please be aware that a coaching relationship is not considered a legally confidential relationship (like the medical and legal professions); therefore, one-on-one communications with your guide/coach are not subject to the protection of any legally recognized privilege. Your guide/coach will not disclose your private information to anyone without your written permission, except as required by law, such as to protect you or another person from harm.
4) Your guide will encourage, coach, and support you, but the journey itself belongs to you. As you listen for God’s voice and discern your steps, you accept full responsibility for yourself and any actions you may take that might result from your Road Ahead group experience.
5) I authorize DPC at FTS, and those acting pursuant to its authority, a non-exclusive, perpetual, royalty-free, worldwide, freely assignable and sub-licensable license to record my participation and/or likeness on a photographic, digital, electronic, hosted media, web-based service or any other medium; use my recorded likeness on a photographic, digital, electronic, hosted media, web-based service or any other medium; use my name and identity in connection with these recordings; use, reproduce, exhibit, or distribute in any medium (e.g. print publications, Internet) my recorded likeness on a photographic, digital, electronic, or any other medium, without restrictions or limitations, for any educational or promotional purpose which DPC at FTS and those acting pursuant to its authority deem appropriate, including promotional or advertising efforts.
6) I release DPC at FTS and those acting pursuant to its authority from liability for violation of any personal, intellectual (including (without limitation) copyright) or proprietary rights I may have in connection with uses of the likeness and recordings authorized above. I waive any right to inspect or approve the final use(s) of the photographic, digital, electronic recordings or any other medium. As to the photographic, digital, electronic images or recordings itself, or any other medium, I understand and agree that DPC at FTS shall have exclusive ownership of the copyright and other proprietary and property rights in the work.
By typing in your name, you agree to the statements above.