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Scholarship Application
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Email
*
Your email
Complete Name
*
Your answer
Phone Number
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Your answer
City, State or Province
*
Your answer
Country
*
Your answer
Birthdate
*
MM
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DD
/
YYYY
Gender
*
Your answer
Racial / Ethnic Identity (check all that apply)
*
Asian
Black
Hispanic/Latinx
Native American or Indigenous
Pacific Islander
White
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Other
Required
Racial - Ethnic Identity - Additional/Other (fill in)
Your answer
Profesion
*
Your answer
Annual Income $
*
Your answer
Are you a student?
*
Yes
No
If Yes, Name of school/program?
Your answer
Which retreat are you applying for?
*
Oct 30 – Nov 7, 2022 / Reconnection Journey -
https://www.ninawasi.com/en/reconnection-journey/
Nov 28 - Dec 6, 2022 / The Colors Within -
https://www.ninawasi.com/en/the-colors-within/
Required
Of the total value of US$ 6,800, how much do you think you can contribute? Please write below the amount with which you think you can contribute to the event. (Since we do not have full scholarships)
*
Your answer
What results do you expect from this retreat?
*
Your answer
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