Fluence Diversity Fund Scholarship Application Form
We offer partial scholarships for most of our trainings. We do not offer full scholarships at this time. Given the limited number of partial scholarships available, we are interested in prioritizing certain factors when considering applicants. These factors include diversity considerations, financial need, and professional background and experience.

In considering diversity, we intend to support applicants who represent or will increase access to services among persons of diverse backgrounds, including but not limited to by virtue of ethnicity, race, sexual orientation, class, national origin, economic background, disability status, and other categories. Please see our Mission Statement for details.

If you would like to apply for a scholarship, please identify the training you wish to attend and complete this form. Scholarship recipients will be notified within 2 weeks of application and given a code to register at the scholarship price. This code must be used within two weeks or the scholarship will be forfeited for the next eligible applicant.

Note: Scholarships apply to the program ticket fee only, and do not cover CE or CME portions of pricing or any lodging or travel.

Note: Scholarship spots are funded partly by donations to the Fluence Diversity Fund, and partly by complementary admission granted by Fluence.
Email *
Which Training would you like to attend? *
What is your full name? *
Please briefly describe your profession and current career status? *
We are especially interested in providing scholarships to participants whose participation will enhance diversity among clinicians educated in this modality and/or the populations to which it is available. How would your attendance at this training enhance diversity in the field and benefit the community? *
Is the training fee a barrier to attendance for you? *
Please provide any additional information that you believe demonstrates the training fee as a barrier for you.
If you are applying to a Reading and Study Group (RSG) or a Clinical Consultation Group (CCG), have you already submitted an application for the group? (Return to the group webpage and hit "get tickets" to access the application.) We can't award scholarships for RSGs or CCGs without a group application.
Clear selection
Submit
Never submit passwords through Google Forms.
This form was created inside of psychedelictherapy.net. Report Abuse