Equity Intersection Scholarship Course Registration Form
Please use this form to request a scholarship for Equity Intersection Courses.  Please note that for some of our courses, we offer several scheduling options.  Please be sure to choose the scheduling option that works best for you.  Once you have completed and submitted this form, and Equity Intersection staff member will be in touch with you regarding your eligibility for a scholarship.
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I am registering for the following course(s) and/or workshop(s): *
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Your name:
Your telephone number:
Your address:
What is the size of your household?
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What is your annual household income? *
A copy of your responses will be emailed to the address you provided.
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