PLT Scholarship Interest Form

First and Last Name: *

Email: *

Phone: *

Area of work: *

What are your intentions behind joining PLT? *

In need of: *

Partial (50%) Scholarship

Full Scholarship

How do you envision implementing the knowledge acquired in PLT?

*

Any prior experience engaging with decolonization work?

*

Prior experience with psychedelics, sacred medicines, or expanded states of consciousness (ex: breathwork):

*

Yes

No

Would rather not say

If you receive a scholarship, are you able to commit to attending at least 8 out of 10 sessions live?

*

Yes

No

Not sure