MAP: Accessible Care & Wellness Program (Home Support)

Welcome to the application for the Mutual Abundance Pathway (MAP) Cohort. 

As a reminder, MAP is a strictly participatory, case-study-driven program for households needing accessible care. Cohort size is limited to ensure deeply dedicated, relationship-centered support. 

Please answer honestly with details about your current needs and what you can commit to. 

Application Deadline: Rolling 

Program Overview: https://drive.google.com/file/d/1IAppJQPJi9svi99ZAgdOTcrrBSPWPchv/view

Website: ekofa.earth

Questions? email: salarah@ekofa.earth

Note: If you are not requiring support due to a financial barrier please do not apply.
You can book a standard Rhythm Session here: https://ekofa.earth/rhythm-session

All answers are kept strictly confidential.
Sign in to Google to save your progress. Learn more
Full Name *
Location/Zip Code *
Email Address *
Phone Number 
 *
Who are you seeking support for?
 *
Which of these household environments do you feel most strongly require support? (Select all that apply)
Which best describes your current need for home support? Select up to three.  *
Required
Program requirements: 

Because MAP is a collaborative, case-study-driven program, active participation is essential. Please check the boxes below to confirm your comittment:  
 *
Required
Program Investment: 

The MAP program rate is a subsidized flat investment of $95 per session for sessions 1–11, and $70 for the final session. Which statement best describes your financial alignment?  
Clear selection
How often do you need support?
Clear selection
What days are generally best for you? Select all that apply.
Clear selection
What times are generally best for you? Select all that apply?
 *
Is there anything you'd like us to know when considering your application?
 *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of ekofa.earth.

Does this form look suspicious? Report

Google Forms