Roots Retreat Women's Workshop Financial Assistance Request Form

Phone

This field is for validation purposes and should be left unchanged.

Roots Retreat Women's Workshop Grant Application

Please complete this form entirely. Note that while we will make every effort to provide some assistance to everyone who needs it, we have a limited amount of grant funds. Individuals are expected to make reasonable efforts to secure assistance from other sources (church, family, friends, etc.) wherever possible.

Name*

First Last

Email*

Phone*

How much of the $500 registration fee are you able to pay PRIOR to the start of the workshop?*

How much are you able to pay off within 90 days AFTER the workshop?*

Have you contacted your church yet for financial assistance?*

Yes
No

What was the result? Has your church agreed to provide any assistance? For how much?

Have you contacted any friends or family members yet for financial assistance?*

Yes
No

What was the result? Has anyone agreed to provide any assistance? For how much?

By checking this box, I authorize Awaken to communicate with me using the information I have provided.*

I agree.

By checking this box, I acknowledge that completing this form is NOT a guarantee of financial assistance.*

I understand.