End-of-Life Doula Scholarship Application

Terms

This is a preapproval form to be considered for any scholarship money raised to help support your tuition. Partial and full scholarships will be given based on this preapproval, funds raised through the nonprofit specific to this scholarship fund ,and at the discretion of the Life & Death Wellness (LDW) Board of Directors.

Individual scholarship donations in your name (if you elect this option) should only be solicited on your behalf after your preapproval has been accepted and you have been notified in writing by Life & Death Wellness.

General scholarship awards will be announced 60 days prior to the scheduled training. Priority is given to those who have attempted to raise funds on their own behalf through our Individual donation program.

A deposit of $500 for the training must also have been received before your application will be considered. The deposit will be returned, minus the adminstration fee, if you are not selected for a general scholarship, have not raised your goal amount through our individual scholarship fund, and decide not to take the training 60 days prior to its start. No reimbursements will happen after this time.

If you elect to withdraw your registration, any money raised on your behalf through the Individual Scholarship program will be forfeited and awarded to another applicant through our General Scholarship fund approved by the LDW board.

If a recipient of a scholarship is unable to attend a training due to extenuating circumstances approved by the LDW Board, the funds will be held in their honor for up to one year and can be used towards a future Inspired Endings EOL Doula training.

No scholarship funds are given directly to the recipient. Full or partial tuition scholarships are paid towards tuition only. Airfare and other travel costs are not included.

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Contact Information*

I am applying for:*

General Scholarship (we have limited funds and thus scholarships may be full or partial tuition coverage)Individual Scholarship Donation in My Name (an approval letter from LDW must be received before funds can be raised in your name through the nonprofit)All of the above

I have made the required deposit of $500:*

YesNo

I have registered for an Inspired Endings EOL Doula Training:*

YesNo

I am planning on taking this training:*

Please briefly describe your interest in Inspired Endings End-of-Life Doula training:

Why are you interested in supporting the dying and their loved ones?

How do you hope to apply what you will learn in this training to serve your community?

If your work serves BIPOC/marginalized communities, please describe:

If you identify as BIPOC or hold any marginalized identities, please describe:

Check annual net family income:

$55,000 or below$56,000 to $100,000$101,000 to $200,000Above $200,000

Are there any extenuating financial circumstances or financial needs you would like to tell us about?

Please upload the following optional documents:

Recommendation Letters (Optional)
Resume (Optional)

Document Upload

Certification of Accuracy*

I CERTIFY ALL INFORMATION PROVIDED HERE TO BE TRUE AND ACCURATE TO THE BEST OF MY KNOWLEDGE. I HAVE READ AND UNDERSTAND THE TERMS OUTLINED IN THIS APPLICATION.

Applicant Signature*

End-of-Life Doula Scholarship Application

Life & Death Wellness believes that end-of-life doula support & training should be made inclusive and accessible to all people regardless of race, gender, socioeconomic status, or marginalized identities.

Terms

Personal

Financial Information

Signature