Retreat Scholarship Application

* These fields are required

1 Retreat Scholarship Application

2 Retreat Request Information

What type of retreat are you applying for? *	Day/Half-Day Retreat Overnight Retreat
If requesting an overnight retreat, how many nights are you requesting? *	One Two (maximum)
Requested Retreat Date/s (for reference only) *	Please note that these dates are for reference only. If your scholarship request is approved, you will be required to complete the corresponding Day or Overnight Retreat Request Form to confirm your retreat dates.
Scholarship Request *	Full scholarship (100%) - Day Retreats only Partial scholarship (75%) - Day Retreats only Partial scholarship (50%) Partial scholarship (25%) Scholarships may cover a portion or the full cost of a retreat. Please indicate your requested level of assistance.
Reason for Request *	Please share a brief statement explaining why you are requesting a scholarship. This helps us understand your needs and allocate resources equitably.
Is this your first time requesting a retreat scholarship at the Peace & Spirituality Center? *	Yes No
If yes, please provide additional details: *
Are you affiliated with a religious or spiritual community? *	Yes No
If yes, please specify: *
Scholarship funds are made possible through the generosity of our donors. Some of our donors deeply appreciate knowing who has benefited from their contributions. If you are comfortable, please let us know how we may share your information with them. *	Share my first name only Share my first and last name Share my name (as specified above) and the retreat I attended I prefer that none of my information be shared Please note: No personal details beyond your selection will be shared without your consent.
Have you ever attended a retreat at the Peace & Spirituality Center before? *	Yes No
If yes, please specify when and which program: *
For Overnight Retreats: Do you have any special needs, or accessibility requirements we should be aware of? *	Yes No
If yes, please provide additional details: *
For Overnight Retreats: Referred by: *
Agreement *	I understand that scholarships are granted once per calendar year, per individual I understand that submitting this application does not guarantee a scholarship I acknowledge that all information provided is true, accurate, and complete. If awarded a scholarship, I understand that I will be required to complete a separate Day or Overnight Retreat Request Form to confirm my retreat dates. If awarded a scholarship, I agree to abide by the Peace & Spirituality Center’s policies and respect the space and its residents.
Address *
Address 2
City *
State/Prov. *
Zip/Postal *
Country *
Signature (please type your full name below as your signature) *	By typing my name, I acknowledge that it represents my official signature and confirms that all information provided in this application is true and complete to the best of my knowledge.
Purpose of Retreat *	Please share a little information about the purpose of your retreat. We may share this information with the Sisters. Thank you!
Where have you been on a retreat in the past? *
What led you to seek a retreat at this time? What do you hope to gain or receive from your retreat? *
Why have you chosen the Peace & Spirituality Center at St. Mary-on-the-Lake for this retreat? *
How did you hear about us?
Email Newsletter	Please send me the email newsletter

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