Breastrest retreat Metastatic Breast Cancer Application Name * First Name Last Name Email * Social Media Handles Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone (###) ### #### Age of Diagnosis * Date of Diagnosis * Type of Breast Cancer * What was going on in your life at the time of diagnosis? * What is your treatment regimen? (please include all chemotherapy, radiation, and surgeries) * Have you have any complications during these treatments? Please explain. * What is your support system like? * Do you have a mental health history? If so, please describe your diagnoses, their symptoms, and necessary medications. * Describe 3 physical challenges that you struggle with the most because of treatment. * Describe 3 mental/emotional challenges that you struggle with the most because of treatment.. * Describe any relational/intrapersonal challenges that you struggle with the most because of treatment. * Group dynamics are important to consider when planning a retreat like this. The goal is to create a safe, supportive, and welcoming space for every Boobie Queen that decides to share pieces of herself with the group. In order to do that, The Boobie Queen Company is very intentional in creating each retreat community by assessing commonalities between applicants as well as what effect each applicant might have on the group. For example, we wouldn’t create a retreat with 1 introvert and 7 extraverts. We also wouldn’t create a retreat for 7 women who did not have children and 1 who did. Building connection would be more difficult in these scenarios. Furthermore, the next set of questions are a way for us to get to know you so we can best serve you by matching you with the right people. There are NO right or wrong answers. Please be honest. How would your best friend describe you? * If single, are you dating? Why or why not? If applicable, describe your relationship with your partner. If applicable, describe your relationship with your kids. If applicable, describe your relationship with your family. What is your enneagram number? If you don’t know, you can take a free test here. What is your Myers-Briggs Personality Type? If you don’t know, you can take a free test here. Are you introverted or extraverted or a little bit of both? Please explain. * Are you good at taking care of yourself mentally and physically? Why or why not? * How do YOU like to be pampered? * Do you have any restrictions with traveling to this retreat? Please explain. * Have you engaged in breast cancer support groups, functions, conferences, retreats, and/or community? If yes, please explain your experience. If no, please explain why. * Thank you for your application! We will reach out to you via email 6 to 8 weeks prior to the retreat to start the interview process. If you have additional questions or concerns, please email queen@boobiecrowns.com. Stay tuned!
