Relief From Within Application

Relief From Within Application

To learn the Transcendental Meditation technique at a reduced rate, donation based, or scholarship—all information kept private and confidential.
Full Name*

First NameLast Name
Contact Number*
Please enter a valid phone number.
Email Address*
example@example.com
City / State*
Zip Code*
Age*
Birthdate*
Are you currently employed?
Occupation*
Full scholarships may be available to the special categories listed below. Please select if one of these applies to you:

Military veteranFrontline medical worker/healthcareEMSFirefighterPolice/law enforcementSurvivor of domestic violenceSeverely impacted by Hurricane Helene
How did Hurricane Helene impact you?*
Your annual household income:*

$200,000 +$100,000 to $199,000$50,000 - $99,000$30 to $49,000Under $30,000
SELECT YOUR COURSE FEE: Please pay as much of the TM course fee as you can, so that our scholarship fund can go further and support as many as possible who need to learn TM, especially those most in need. Half of the standard TM course fees helps someone learn who cannot afford to pay—veterans with PTSD, survivors of domestic violence, and others at risk from traumatic stress.
I can pay:*

My designated course fee$100 per month for 4 months$75 per month for 4 months$50 per month for 4 months$25 per month for 4 monthsRequesting further financial help (may be available to those whose household income is under $30,000 or who were severely impacted by Hurricane Helene). Scholarships subject to approval by our finance board. Feel free to contact us to check on the status of your application.
If you are unable to give back at this time, and you request full scholarship: What are your circumstances?
Signature*

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