Dare to Thrive Renewal Application

The Dare to Thrive Renewal Program is made possible by the generosity of Project Pink’d supporters and is free to survivors selected. The 2020 program is available to 20 women who live in Nebraska or Western Iowa. Each woman will be gifted a grant (valued at $2300) to join the retreat, and attend Thriving Circle group sessions. 

Application Process

  1. Complete the Online Application by 11/15/2019
  2. The online application is the first step only.  It is not confirmation of your selection/participation. Your information will be forwarded and you will be contacted by a member of our program team.
  3. Participants will be selected and notified by December 15, 2019.
  4. The 2020 Dare to Thrive Retreat will be held on Friday, April 17 - Sunday, April 19, 2020. 

Project Pink’d Dare to Thrive Application

ex: 1950
*date of original diagnosis if you have been re-diagnosed
What healthcare system did you receive treatment?
I am at least one-year post-treatment.
I understand and agree I am required to attend the retreat weekend experience in April
I understand and agree I am required to participate in 4 monthly Thriving Circles
The Retreat, private coaching and Thriving Circle sessions are highly interactive, engaging, and reflective and are professionally facilitated in an environment based on trust, openness and respect. As a participant, I understand and agree that I am fully responsible for my physical, mental and emotional well-being during the Renewal Program, including my choices and decisions.
I understand that the Renewal Program is not therapy. It is not a substitute for counseling, psychotherapy, psychoanalysis, mental health care or substance abuse treatment and I will not use it in place of any form of diagnosis, treatment or therapy.
I understand that the Renewal Program is a vehicle for achieving awareness and results but that I am the driver. The facilitators will be a mirror for me and invite me to look at new ways of thinking and being. They may challenge my beliefs and shed new light on my actions. However, they do not confront, judge or make me wrong. Only I decide what to change in my life.

Let's Get Started!
If you could change 3 things about your current situation, what would they be?
When we see you at the end of the 5-month Renewal Program and you’ve gotten what you wanted – describe what is different? (What might you see, hear or experience differently)

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