Liberation Pathways Scholarship Application
This Liberation Pathways Scholarship fund is funded by contributions by community members in order to provide services offered via Liberation Pathways LLC and affiliated practitioners to people from historically oppressed and/or marginalized populations. This fund can cover individual services as well as group classes and events. It does not cover the cost of retreats at this time. You might be eligible to receive either partial or full scholarships based on your ability to pay and support this work. Although one of the aims of Liberation Pathways is not to turn anyone away due to lack of funds, we are limited in our capacity to accommodate everyone sometimes, due to space and time limitations, given the small size of our practitioner team. There is a likelihood that some applicants will be placed on waiting lists or offered group classes/events as alternatives to individual work. Please note that our classes and events are not therapy and do not replace individual therapy.  Folx are encouraged to continue seeking assistance through other means if our individual therapists are at capacity.
Sign in to Google to save your progress. Learn more
Email *
What is your name? *
What do you prefer to be called? *
Phone Number
Full Street Address
What are your pronouns? *
How do you identify (i.e. Latinx, Black, Cisgender, Queer, etc)? *
Please share a little bit about yourself. *
Why are you interested in obtaining a scholarship fund at this time? *
Have you engaged in Liberation Work before? If so, please share a little bit about your journey. *
What do you think is the relationship between Liberation and mental/spiritual/physical health? *
When it comes to discussing and sitting with uncomfortable topics, how would you describe your aptitude? *
What class or service are you interested in?
What role do you think healing and liberation from frameworks and systems of oppression can have in your life? In your community? In the planet? *
We find that it can be empowering and helpful to invest in our personal growth as much as we are able to. Are you able to contribute any amount toward the service/class that you are interested in participating in? If so, how much?
How did you hear about the scholarship fund?
I understand that Liberation Pathways is a safe space and healing haven and I am willing to participate in a respectful manner in accordance to group norms. *
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy