Bursary Application Form

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Root in Nature is committed to enabling accessibility to its courses and community to all who share our passion for connecting people with plants and nature. We provide up to five reduced rate, 50% off spots in our course per quarter to individuals whose financial circumstances are a barrier to enrolment.

If you would like to access one of these spots, please fill in this form. You will be contacted by the end of each quarter with the results of your application (end of March, end of June, end of September and end of December).

Full Name *

Email address *

My pronouns are:

She / Her

He / Him

They / Them

Prefer not to disclose

Clear selection

Please complete the statement that you feel most accurately represents yourself.

I am a/an...

recreation therapist or other allied health professional

practitioner of horticultural therapy

practitioner of therapeutic horticulture

Student

Not currrently employed

Other:

Please tell us where you are located. *

Canada

United States

Australia

United Kingdom

Other:

Why are you interested in participating in the Intro to Therapeutic Horticulture course and what do you hope to accomplish with this training? *

How does your current education, skill set or experience relate to the course topic - for example, human services, gardening, volunteering, etc.? *

Please briefly describe your financial need for this bursary. *

Personal Information

We would greatly appreciate it if you would be willing to share how you identify yourself. You can choose not to respond to these questions by selecting “prefer not to disclose”.

The racial and ethnic group that best describes me is:

Please select all that are true for you.

Black (e.g. African, Caribbean, North American, Black British)

East Asian (e.g. Chinese, Japanese, Korean)

South Asian (e.g. Bangladeshi, Bhutanese, Indian, Nepali, Pakistani, Sri Lankan)

Southeast Asian (e.g. Cambodian, Filipino, Indonesian, Laotian, Malaysian, Singaporean, Thai, Vietnamese)

Hispanic or Latinx

Indigenous (e.g. First Nations, Métis, Inuit, Native American, Aboriginal or Torres Strait Islander, Māori, Native Hawaiian or other Pacific Islander)

Middle Eastern or North African

White (e.g. European, North American, Pakeha)

A racial or ethnic group not listed

Prefer not to disclose

Required

We understand the preceding list may not capture every racial and ethnic group and that language is ever-evolving. If you wish to share more details around how you identify, please do so here.
*

Do you identify as a person with a disability?
*

Yes

Prefer not to disclose

I am:
Please select all the ways you would describe your sexuality and gender. *

Woman

Non-binary

Man

Bi-sexual

Gay

Lesbian

Queer

Straight

Cisgender

Transgender

Two-Spirit

An identity or orientation not listed

Prefer not to disclose

Required

We understand the preceding list does not capture every orientation and identity and that language is ever-evolving. If you wish to share more details around how you identify, please do so here.

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