Partial Scholarship Application

The Woman Within Weekend is a life-changing experience. Our hope is that no woman would miss out on this opportunity due solely to financial constraints. A woman who truly cannot afford the entire Woman Within Weekend fee may request financial assistance here.

Our Financial Assistance Policy is to honor and acknowledge a woman’s request for assistance and provide partial financial aid to a limited number of women each weekend on a first-come, first-served basis.

To request a partial scholarship application, complete the form below. Your information submitted here is secure and will be held in confidence. Please contact scholarships@womanwithinwesternusa.org if you prefer to apply by mail or have questions.

Thank you,

The Scholarship Committee
Woman Within Western USA

Beth Zare
Director of Development
Woman Within Western USA
Representing the Scholarship Committee

Please feel free to contact me with any questions or concerns.
Email

Scholarship Application

Name*
First Last
Phone*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Enter Email Confirm Email
Event*
I am requesting a partial scholarship for:
- Woman Within Weekend
- Woman Within Circle Training
- Other
Location*
Enter location and date:
Other Event
Event type, location, and date
*
Briefly state the reasons your are requesting financial assistance:
MONTHLY INCOME
Salary after taxes
CS
Child Support
(SSI)
Government support (SSI)
SFA
School financial aid
OFA
Other financial aid
Total monthly income
Section Break
MONTHLY EXPENSES
Housing
CAR LOAN
Car loan
CAR INS
Car insurance
GAS
Gasoline
FOOD
Food
UTIL
Utilities (phone, internet, electricity, gas, water, etc.)
HEALTH INS
Health care
OTHER
Other monthly expenses (credit card, student loan, etc.)
TOTAL EXP
Total Monthly Expesnses
*
By checking the box below I am confirming the information provided on this form is true and correct. I agree to abide by all Woman Within Western USA policies and procedures if approved.
Confirming this information is accurate.
Comments
This field is for validation purposes and should be left unchanged.

Partial Scholarship Application

Scholarship Application

Section Break