Wheel of Consent Workshop: Scholarship Application

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

We will be reviewing scholarship applications as they are received. We will reach out to you to schedule a 20 minute call to connect with you within a week of receiving your application.

Email *

Participant Name *

Are you someone who identifies as BIPOC? *

Yes

Is there anything you feel would be helpful for us to know about you and/or your current situation? *

What is your primary reason for taking this workshop? *

What are you hoping to take away from this workshop? *

Are you willing to follow the group guidelines (detailed here: https://www.tickettailor.com/events/robyndalzencoaching/459615#)? *

Yes

What are barriers you can identify that might get in the way of your participation? *

What can you do to resource your participation? *

Is there anything about your identities that you would like us to know? *

Is there anything you need from the facilitators to feel supported in the space? *

Where in the world are you located?

How did you learn about this workshop?

Would you like to be added to our mailing list?

Yes

Clear selection

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms