Scholarship Form | Grounded Journeys

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SCHOLARSHIP FORM

First name*

Last name*

Email*

Phone

Instagram Handle ( If you have one )*

Country of Origin *

Retreat you would like to attend*

Why would you like to join our retreat?*

Why are you unable to attend without financial assistance?*

What do you hope to achieve by attending a retreat with us?*

Have you ever been on a wellness retreat before? If so, which one and what was the theme?*

Do you identify as a marginalized group?

Yes

No

Have you been recently impacted by the Los Angeles fires or floods?

Yes

No

Check to verify that you understand that if chosen, this scholarship does not include travel expenses like flight to location.

Is there anything else you would like us to take into consideration?*

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