CSBD Hope for Healing Registration Scholarship
Please fill out the questions below to submit your application to attend at a price you can afford. There is no fee to apply.
Name
*
First Name
Last Name
Email
*
Confirmation Email
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Describe your journey.
*
I am a clinician.
I am seeking recovery from CSBD.
I am a partner of someone struggling with CSBD.
I prefer not to say.
Other
What challenges are you currently facing in your healing or recovery journey? If there are multiple, feel free to share which feels most significant right now.
*
What do you feel is making healing or progress difficult at this time?
*
What are you hoping to receive or experience at the CSBD Hope for Healing Conference?
*
What would you like us to know about your financial situation?
*
What amount are you able to contribute to your registration?
Please verify that you are human
*
Let's stay in touch
Please add support@csbdhopeforhealing.org to your allowed email addresses as our communications will come from this email. You can always reach out to this same email address with questions or status on your application.
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