Healing Arts Institute (Heal): Cohort 5 Application Fall 2020
Thank you for your interest in applying. Deadline: October 21, 2020
Dates for Fall 2020: October 25 | November 1, 8, 15, 22, 29 | December 6, 13
Email address *
Phone number *
First Name *
Last Name *
Preferred Name & Pronouns *
How do you self-identify? (please include race/ethnicity as this is a BIPOC-centered program for all; and any other identities that are important to you): *
Mailing Address (Street, City, State, Zip) *
Organization Affiliation (N/A if none) *
Referral Information - How did you hear about the Healing Arts Institute *
1. What inspired you to apply to be part of the Fall 2020 cohort of Heal? (250 words max) *
2. What are you hoping to gain/sharpen/hone in on during the program process? (skills, experience, exchanges, etc.) (250 words max) *
3. What are you bringing into the cohort that you would like to explore, develop, and/or exchange during this time? (values, skills, ideas, questions etc.) (250 words max) *
4. Are you able to commit to participating in the full 30-hour* commitment? (virtual; 30 hrs includes sessions and coaching calls) *
4b. If your response to #4 is "no" or "other," please explain:
5. Are you in need of scholarship or sliding scale based on financial need? (limited scholarships available; if yes, you will receive a scholarship form after submitting the application) *
Days/Times Available for Interview Call *
6. Please share anything else you would like to; thank you for applying!
A copy of your responses will be emailed to the address you provided.
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