If you are interested in attending one of our upcoming retreats with your friend or loved one, please fill out and submit the following online application. Your responses will be kept confidential and only shared with the retreat staff. If you prefer, we can also send you a copy of the form to be completed offline and submitted – please contact firstname.lastname@example.org if interested.
**NOTE: This form does not allow you to save your progress, so we recommend completing in one sitting or writing your answers in a word document and pasting them into this form below. Click here for a complete list of questions.
If you are a Cancer Survivor interested in attending the retreat, please fill out this form instead.
Smith Center for Healing and the Arts : community. creativity. cancer support.
1632 U Street, NW, Washington, DC 20009 |P 202.483.8600 F 202.483.8601