Mindfulness for Stress - Bursary Request Form

Mindfulness for Stress: Bursary Request
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Date of birth*

DayMonthYear
Date
E-mail*
example@example.com
Phone number*
Which Online Mindfulness for Stress course date you would like to attend (if possible, please choose more than one)?*
Date unavailable? Click here to join the waitlist
You can still be added to a waiting list. Please let us know which one you would like to get contacted in case we have a place available*

OMfS 20 September 2025, Saturdays 10amOMfS 21 October 2025, Tuesdays 6pmOMfS 14 January, Wednesdays 18.30OMfS 25 January, Sundays 10.30amOMfS 17 February, Tuesdays 16.30OMfS 19 March, Thursdays, 18.30
Under what circumstances are you in need of a bursary?*
We ask you to consider how much you are able to fund yourself and we will cover the remainder from our bursary fund.
How much are you able to pay (see notes above)?*
Please provide any other information you think is relevant to this application (that can include your health condition for the Health course)
Funding Monitoring Information
Why do we need this information?

Collecting this information will provide useful anonymous data that may help Breathworks to secure funding in the future. This in turn will help us award bursaries to more people, so more people will be able to benefit from mindfulness training.

The monitoring information has no basis in our decision-making process and this data will never be shared with anybody and will be held securely in accordance with the standards set out in the GDPR and the Data Protection act 2018.
Do you live with a long term physical or mental health condition?*

YesNoIf yes, please provide details of the condition
Do you have a disability?*

YesNoPrefer not to say
Are you currently unemployed?*

YesNoPrefer not to say
Are you from Black, Asian, Minority Ethnic (BAME) heritage*

YesNoPrefer not to say
Do you identify as LGBTQ+?*

YesNoPrefer not to say
Privacy & Cookies Policy
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Thank you for completing the application. Please click submit and your application will be reviewed by a member of the team.
OpenCRM Subject
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Mindfulness for Stress: Bursary Request

Funding Monitoring Information

Privacy & Cookies Policy