Scholarship Application

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* These fields are required

1 Welcome

2 People in your group

3 Participant Info

Title *	Example: Mr/Ms/Mrs, Sister, Reverend
Address *
Address 2
City *
State/Prov. *
Zip/Postal *
Country *
Email newsletter	Please send me email newsletters
For which program are you requesting a learning grant for? *
Date of Retreat *
Retreat Fee *	Please enter the fee of the retreat.
What is your present source of income? (i.e., job, disability, social security, etc.) *
Do you have any other sources of support? (i.e., continuing education money from employer, faith community, etc.) *
Are your monthly expenses over, under, or compatible with your income? *
How much money do you feel capable of contributing toward this cost? *	Please enter dollar amount.
Please write a brief explanation of your circumstances and reasons for requesting financial assistance. *