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One Time Request Form
Welcome! We’re so happy you’re here! This is our uniform, 1 time form to ensure this work & community are a right fit for you at this point in time. Please answer the following brief questions as well as read through & check off our community’s policies, privileges & disclaimer. Please note: this form's designed to be filled out in one sitting, so as to avoid the process being timed out & having to start again, please be sure to start this when you have at least 15-20 consecutive minutes free. Thank you!
Jen Mac’s group & 1 on 1 programs provide excellent, secondary support to all enrolled! This means there’s support during each actual class or session via Jen's teachings, her in class or in session exercises, her homework assignments & the community you’re able to connect with here! Because we’re a community of hundreds though, it’s not physically possible for Jen to give additional private time outside of classes or sessions. Therefore, we require all participants have a primary support system already in place so you're always fully supported! This means you have any or all of the following: supportive parents(s), supportive sibling(s), supportive spouse or partner, supportive friend(s), supportive colleague(s), supportive therapist, support group, supportive clergyman/woman, supportive spiritual/religious community of some kind.
*Please Check Off Each Box After Reading
I, [name], hereby declare that I am of sound mind & body while signing up for & participating in any & all classes/programs/tele-programs with Jen Mac’s Something Different For Women.
Furthermore, I understand that all of these classes/programs/tele-programs are taught to enhance my life & merely offer suggestions to me. I understand that all of these classes/programs/tele-programs & the class/program/tele-program leader do not instruct me to do anything I do not wish to do.
I also understand that the program leader for “Something Different For Women, LLC”, Jennifer Macaluso-Gilmore, does not proclaim to be a therapist, guru, PhD. or M.D. of any sort but simply an instructor, teaching philosophies & theories she has learned through her own personal education & growth. It is with the above understandings that I join in this/these class(es)/program(s)/tele-program(s). I understand that my electronic signature below constitutes a legal signature confirming that I acknowledge & agree to the above Disclaimer. My signature will be represented as follows: /First Name Last Name/.
Please type your name below (exactly as it appears above & as stated in the above paragraph, with a forward slash before your first name & a forward slash after your last name):
Apr 19, 2021
Thank you for submitting our one time, uniform request form. You matter! Someone will get back to you within 72 hours.
Jen Mac & The SDFW Crew
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Jen Mac & The SDFW Crew