BIPOC Scholarship Application

BIPOC Scholarship Application - ADULT

This Scholarship is for people who identify as BIPOC (Black, Indigenous, and People of Color)
I understand this scholarship is offered to applicants who identify as Black, Indigenous, and People of Color.
Applicant's Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
E-mail*
example@example.com
Phone Number*
Alternative Phone Number
Program you are interested in attending*
Date of program*
Please select the scholarship you would like to apply for.
Tell us about yourself and your family’s background.*
Describe your relationship with the natural world and why you are interested in this program. What are you hoping to learn?*
*Scholarship applications will be reviewed and offers will be made once the minimum number of registered participants has been met*

Applicants may reapply one calendar year after their last scholarship offer. In order to share this opportunity with as many people as possible, priority will be given to first time scholarship applicants.

Note: Submission of a scholarship application does NOT automatically register a participant for a class/program or reserve a space in that class/program. In order to register, please call our office at 949-709-5777 or email info@earthrootsfieldschool.org.

I certify that the above information is accurate to the best of my knowledge.
Signature of Applicant*

Clear
Today's Date*

MonthDayYear
Date
The number of scholarships awarded, will be determined by donations provided and the number of applications received. If there are more BIPOC Scholarship applicants than there are spaces available, recipient names will be added to a lottery and drawn at random. In the event that you are not selected for the BIPOC Scholarship, and if you would like to be considered for a Needs Based Scholarship, please also fill out a separate Needs Based Scholarship Application.

Earthroots Field School PO Box 504, Trabuco Canyon, CA 92678 info@earthrootsfieldschool.org

Earthroots Field School does not discriminate on the basis of race, color, religion, age, sex, disability, ethnic origin, or sexual orientation.
Earthroots Field School | PO Box 504, Trabuco Canyon, CA 92678 | 949-709-5777
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BIPOC Scholarship Application - ADULT