WABT RETREAT SCHOLARSHIP APPLICATION 
WEAREBRAVETOGETHER.ORG 
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Email *
Email: *
First Name: *
Last Name: *
Street Address *
City/State/Province *
Country *
Phone: *
Roommate Preference: *
Dietary Preference: *
Emergency Contact: *
Emergency Contact Phone: *
Which retreat are you applying for scholarship? *
Please write a one paragraph testimonial of what being a member of WABT has meant to you, in your journey as a mom caring for a child with special health-care needs. OR write a paragraph about your need for respite and what you look forward to in attending this weekend retreat.  *
I understand the WABT Retreat Scholarship Application Process and agree to its policies and procedures. Link Here *
Required
Digital Signature

*I understand that by checking this box, I am providing a legally binding electronic signature equivalent to a handwritten signature. I confirm that I have read, understood, and agree to the terms and conditions.
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Required
Date *
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A copy of your responses will be emailed to the address you provided.
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