InsightLA Support Application
Thank you so much for your interest in InsightLA! Before we can offer you financial support, we ask that you fill out our application so we can better understand your needs. Please keep in mind that applications may take 3-5 business days to process.
Email address *
Name: *
Your answer
Today's Date: *
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Phone Number:
Your answer
I am applying for: *
Please list the name of the class and who the teacher is that you are requesting financial aid for: (example: Basics of Mindfulness - Celeste Young) *
Your answer
What is the start date of the course? *
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What is the base cost of the course? *
Your answer
Are you currently employed? *
If you answered "yes" above, please tell us your occupation:
Your answer
Gross annual household income: *
Number of people supported by your income: *
Please tell us a little bit about yourself: your current economic situation, why you're interested in this class/event and what taking it would mean to you! *
Your answer
Would you be willing to volunteer for this class/event? (This means arriving early to the class/event to set up, staying late to help clean our space, and providing any additional assistance the teacher might ask.) *
Do you identify as a person of color?
How do you identify your racial or ethnic heritage?
Your answer
How do you self-identify your sexual orientation?
Your answer
How do you self-identify your gender?
Your answer
Do you identify as a person with a disability or disabilities?
Your answer
What is your Zip Code?
Your answer
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