Donation Scholarship Application

Donation Scholarship Application
Participant Information
Full Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
Ceremony Date Applying For*

MonthDayYear
Date
Scholarship Request
Are you requesting a reduced minimum donation amount or a split donation plan for the full donation amount?*

Requesting one time reduced donation amount. (Full donation amount with $50 reduction)Requesting split donation plan (full minimum donation amount split over 2 donations)
We kindly ask that you please be as detailed and as honest as possible for the below sections. 🙏
Why are you seeking a reduced donation or split donation plan for this ceremony?*
What draws you to this ceremony at this time in your life?*
How do you feel this experience may support your healing, growth, or integration?*
Additional Notes or Thoughts About Your Donation
Reciprocity & Community Care
In what ways do you currently give back to your community, or how might you be open to giving back in the future?*
Is there anything else you would like us to know when considering your application?
Agreement
Agreement Signature (typed)*

Clear
Date of Signature*

MonthDayYear
Date
Thank you for your application. We will review it carefully and get back to you soon.
Should be Empty:

Participant Information