Scholarship/Custom Payment Plan Application

Name *

First

Last

Email *

Main Phone *

Alternate Phone

When do you hope to start our work together? * *//

Do you need a scholarship in order to access my services? *

No
Yes. Without a scholarship, I will not be able to participate at this time.
Maybe. I am seeking alternative ways to generate payment and I'm not sure yet what I can do OR I have other resources I may be able to tap however this would create a significant strain on my ability to meet my basic needs.

Is there anything about your identity that aligns with the community descriptors listed on my scholarship page? *

Yes
No

Please read about available discounts and scholarships here.

If yes, please explain. *

Which scholarship(s) are you applying for? (Check appropriate box(s) if you are applying for a scholarship.)

Person of Color Scholarship
DACAmented / Asylum Seeker Scholarship
Social Justice Activist Scholarship
Single Parent 25 or Under Scholarship
Personal Scholarship* (be sure to answer tuition question.)

Please read about available discounts and scholarships here.

Custom Payment Plan: Do you need an extended payment plan in order to make this work accessible for you?

Check if yes.

I typically require full payment in advance for drop-in session work. For my Intuitive Healing and Mentorship program, I typically offer a full payment or a seven-month payment plan. If you need an alternative accommodation, please check this pox.

Before requesting an alternative payment plan or Personal Scholarship, please take time to really consider:

What amount would be sustainable for you to contribute toward your tuition costs?

I trust you to make an assessment about what you have the capacity to pay. My suggestion is to take a look at a budget calculator and see what you can really afford at this time. There are many free online tools that may help you look at your finances prior to filling out the application below. Google “budget calculator” if you need help finding one or use one of the tools below. 🙂

Here is a simple budget Calculator from Quicken: https://www.quicken.com/budget-calculator
Alternatively, it might be helpful to Make a Budget to see whether you’re making more than you spend or spending more than you make:
Federal Trade Commission Fillable spreadsheet: https://www.consumer.gov/sites/www.consumer.gov/files/pdf-1020-make-budget-worksheet_form.pdf
Worksheet from Nerd Wallet: https://www.nerdwallet.com/blog/finance/budget-worksheet/
or any of these many templates: https://www.nerdwallet.com/blog/finance/free-budget-spreadsheets-templates/

PLEASE NOTE: I am not endorsing any of these companies or their services. I am simply pointing you to some quick and free budget calculators.

Custom/Extended Payment Plan Request

Please outline your custom/extended payment plan request.

**Why would you like to receive this scholarship? *

**What do you hope to gain from our work together? *

**How will you take the benefits of your experience out into the world to help others? *

Please tell me more about your CURRENT Social Justice Activism *

Please provide a brief statement of your financial need. *

**The general tuition for the Intuitive Healing & Mentorship Program is $3,845. Typically payment is split up into a payment plan as follows: $450 initial establishment down payment + 7 monthly installments of $485. What amount would be sustainable for you to contribute toward your tuition costs? *

Captcha *

What is the second letter of the alphabet?

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Before requesting an alternative payment plan or Personal Scholarship, please take time to really consider:

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