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Wild Belonging Financial Assistance Application
It is important to us that our programs are as accessible as possible. If you find that the lowest sliding scale offered is still a stretch for you, please fill out this form so that we can better understand your needs. We offer financial assistance to help people participate in our offerings who are unable to do so without financial assistance. Priority is given to those who belong to cultural, racial, economic and gender groups that have been historically underrepresented and are currently underserved.
We find that participants who contribute something financially usually are much more engaged, therefore we ask everyone to contribute something that feels affordable and manageable. Our intention is make our programs accessible to as many people as possible so please consider this when thinking about the amount you can contribute.
Flexible payment plans are available for financial assistance recipients.
We will contact you shortly with details regarding the status of your application.
Questions? Email
infowildbelonging@gmail.com
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* Indicates required question
Name of Program
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Your answer
Date(s) of Program
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MM
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DD
/
YYYY
Full Name
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Your answer
Date of Birth
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MM
/
DD
/
YYYY
Pronoun (she/her, they/them, he/him, etc.)
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Your answer
Email Address
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Your answer
Phone number
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Your answer
What barriers make it difficult for you to participate in this program without financial assistance?
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Your answer
Do you belong to any of these historically disadvantaged and marginalized groups? Please select all that apply:
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BIPOC (Black, Indigenous, People of Color)
LGBTQIA+
Working Class/Low Income
Disabled
Prefer not to answer
Other
Required
Please share your intention for this retreat. Why are you interested in this program? What calls you? Why does this matter to you?
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Your answer
How much are you able to pay for the program or retreat including deposit?
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Your answer
How did you hear about this program?
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Your answer
Do you have any accessibility or other needs that we should know about to support your participation?
Your answer
Anything else you would like us to know?
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Your answer
We appreciate your interest in our programs. Once we've received your application, someone from our team will contact you shortly. Thank you!
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