Alliance Mentoring Groups Registration
2026-2027
Name
*
First Name
Last Name
Preferred Pronouns:
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
I have previously participated in the NWAPS Mentoring Groups Program before:
*
Yes
No
Graduate School Attended:
*
Degree Completed:
*
Supervisor/Consultant:
*
If you are not yet licensed, where are you in the process?
*
Please briefly describe your practice:
*
Number of years in practice (post graduation):
*
What motivated you to join a mentoring group? Please briefly describe what you hope to gain from your mentoring group experience.
*
Are there areas of development that you hope your group will focus on? These areas might include professional community building, psychoanalytic theory, case consultation, social justice and psychotherapy, and private practice building, among others. What are you interested in?
*
What is your experience with group participation and process? In your experience, what makes for a good group?
*
Do you have any hopes or concerns related to group dynamics, identity and representation that you'd like to share with your mentor ahead of meeting as a group?
*
Please select one mentoring group
*
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Group hosted by April Crofut, MD
$150.00
$
150.00
Group hosted by Jamie R. Friddle, MA, LHMC
$150.00
$
150.00
Group hosted by Carol Poole, MA, LMHC
$150.00
$
150.00
Group hosted by Kim Richan, LICSW
$150.00
$
150.00
Group hosted by Rebecca Brabo Silva, MA, LMHC
$150.00
$
150.00
Group hosted by Coll Thompson, MA, LMHC
$150.00
$
150.00
Group hosted by Jordan K Wolfe, LMHC, CGP
$150.00
$
150.00
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