JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Living Cult Free SCHOLARSHIP FORM
Please complete this form if you would like to apply for a scholarship. NOTE: All information will reviewed by the scholarship team and will be kept confidential.
* Indicates required question
Email
*
Record my email address with my response
Please share your name or
pseudonym
*
Your answer
Are you a survivor of spiritual, religious or cultic abuse? Please share a little about you and why you are applying for the scholarship.
*
Your answer
What event or class would you like to attend?
*
Reclaiming Autonomy through the Written Word Writing Symposium on March 29, 2025
Reclaiming Autonomy through the Written Word Writing Symposium on SEPT 27, 2025
A different class
If you would like to attend a different class, please share details of the class or event here.
Your answer
Are you applying for a full or partial scholarship? A full scholarship is $40. A partial scholarship is $20.
*
I am applying for a partial scholarship.
I need a full scholarship in order to attend.
I am applying for either full or partial scholarship.
I am not sure. (feel free to share more below)
Please share anything else you would like the volunteers at Living Cult Free to know, including why attending this event is important for you at this time and what you hope to gain by attending it.
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of gerettebuglion.com.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report