Be The Change • The Netherlands 2019
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Email *
First & Last Name *
Preferred Name or Nickname (optional)
What dates are you wanting to attend? *
What inspires you to join this gathering? What are you hoping for from this experience? *
Meals
There will be catered meals and snacks for the Weekend gathering, beginning with dinner on Friday, August 30th and ending with lunch on Sunday, September 1st. (For the additional three days of the 5-Day Deep Dive, we will be a smaller group, so during these additional days we will organize our own meals.)
Do you have any dietary restrictions? *
Accommodation
The Weekend venue and accommodation will be at Boswijk Instituut, 2 M, Beukenrodelaan, 3941 ZP Doorn, Nederland. Please enter your accommodation preferences below.
How many people are you willing to share a room with? Please state your 1st, 2nd and 3rd preference, or leave this blank if you have no preference at all
1 person room
2 person room
3 person room
4 person room
5 person room
1st preference
2nd preference
3rd preference
Clear selection
Would you prefer a mixed gender or women/men only room?
Clear selection
Please tick which of these is true for you
Is there someone else coming to Be The Change with whom you would like to share a room? Please write their full name
Sliding Scale Requested Contribution
We aspire to make this gathering as financially accessible as possible. We also have certain costs, including renting the venue & accommodation, getting meals catered, and organizing and facilitating the gathering. So, we request a contribution on a sliding scale:

• Regular Contribution: covers the costs of venue, accommodation, meals, facilitation, and organizing
• Community Supporter: covers all above costs AND helps support people experiencing financial hardships
• Discounted Contribution: limited number of places available for people experiencing financial hardships (if it is not possible for you to contribute at the discounted rate, please make a Request for Financial Assistance below)


Be The Change Weekend (includes venue, facilitation, accommodation & meals):
• 250€ Regular Contribution / 325€ Community Supporter / 175€ Discounted Contribution

Be The Change Weekend + a Deeper Dive into Conscious Community (includes 3 additional days venue & facilitation):
• 400€ Regular Contribution / 500€ Community Supporter / 300€ Discounted Contribution
Method of Contribution *
Request for Financial Assistance
If you are requesting financial assistance, please describe: 1) your life circumstances, 2) the amount you are able to contribute, and 3) the specific amount of financial support you are requesting. (Financial assistance will depend on other participants contributing at the higher end of the sliding scale, and so your registration will only be finalized once these funds have been confirmed.)
Response
Thank you!
Thank you for joining us. We are very excited for this shared exploration!
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