Haven membership subsidy request form for May
What is your name?
What is your email address?
What is your membership level?
Nights & Weekends
What level of subsidy are you requesting for May?
25% off your current membership
50% off your current membership
75% off your current membership
What type of worker are you?
Small business owner
Independent contractor/ consultant
Non profit employee
What type of business loss have you experienced?
This is for aggregate purposes only - we are getting asked about the financial impact on our members from outside sources and would like to have a sense of how this crisis is impacting our membership.
I was laid off temporarily
I lost my job permanently
I have taken a pay cut
I am a small business owner and my business is temporarily closed
I am a small business owner and my business is still open but revenue has decreased
I am a contractor/consultant and my revenue has decreased
Any additional questions or comments?
Please type your name to certify that you are experiencing financial strain during this time and need a temporary subsidy in order to continue your Haven membership, and that you understand that you will need to reapply for a subsidy each month.
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This form was created inside of The Haven.