Scholarship Application Form
Please complete this form to apply for a scholarship for the 6-day "Wise Speech Retreat" with Donald Rothberg & Oren Jay Sofer August 20 - 25, 2019.
First Name *
Your answer
Last Name *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
The registration fee for this retreat is $350. What is the total amount are you able to pay? *
(Enter the total amount you can pay for this retreat)
Your answer
Participants are requested to attend the entire retreat, 9am - 5pm daily, Tuesday - Sunday. Are you able to attend all 6 days. *
Are you interested in work trade? *
(If we are unable to offer you a scholarship for the total amount you are requesting)
If yes, what skills or experience are you able to offer?
(Check all that apply)
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service