Training Program Scholarship

This scholarship is intended to help support minority groups including but not limited to Black, Indigenous and People of Color (BIPOC), LGBTQIA+ and anyone needing financial assistance.

*You will be informed if you have been awarded a scholarship no less than 2 weeks from the beginning of the training. Please note that you may be required to provide documentation to support the information that you provide. All information will be kept confidential.

“The mission of the Pennsylvania Gestalt Center is to provide a safe and supportive environment for personal growth and change with emphasis on the development of self-awareness and healthy contact with others, your environment, and yourself.”

You may apply for the scholarship by submitting your information below. If you prefer, you can download the application and send it to us at pagestalt@comcast.net.

Comments

This field is for validation purposes and should be left unchanged.

By filling out this form you are agreeing that you would be able to commit to the above requirements.

Name:(Required)

First Last

What pronouns do you use?

Date of Birth:(Required)

Address:(Required)

Street Address Address Line 2 City State ZIP Code

Phone number:(Required)

Email:(Required)

Ethnic origin:(Required)

Hispanic

Non-Hispanic

Race:(Required)

Asian

Black

White

Other

Race - Other (please specify):

How did you hear about the Pennsylvania Gestalt Center?(Required)

Have you attended Pennsylvania Gestalt events previously?(Required)

Yes

Have you previously received a scholarship from the Pennsylvania Gestalt Center or the Mariah Fenton Gladis Foundation? If so, please specify.(Required)

Why are you interested in joining the Training Program?(Required)

Please let us know about your background and whether you are a clinician(Required)

Please let us know why you need financial support to join the Training Program.(Required)

Is there anything else you would like us to know about you?(Required)

The Training Program cost is $3000 yearly, which does not include the additional cost of the weekend workshops or books. How much would you be able to contribute towards your participation in the Training Program?(Required)

Please include a letter about how the Training Program fits into your personal and professional goals.

Please note that in addition to this form, applicants will need to be interviewed by 3 faculty members.

Scholarships for the Pennsylvania Gestalt Center’s Training Program will be assessed on a yearly basis.