National Faithlands Gathering 2021 Participant Financial Assistance/Scholarship Request

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Thank you for your interest in the National Faithlands Gathering 2021. All individuals that could benefit from financial assistance are encouraged to apply! We hope to be able to serve as many as possible.
Applications must be received via this Google Form. If you have questions or technical difficulties contact info@interfaithfood.org or (707) 634-4672. A small, committee will review applications, and keep your answers confidential. Review will begin 7/20 and then on a rolling basis until travel funds/scholarships are all committed.

Filling out this form and hitting SUBMIT will automatically submit application to Interfaith Food and the National Faithlands Gathering planning team.

Please Note: This Google Form does not save draft responses. All answers must be submitted together at one time. (Be sure to save another copy in a different program for your records, if needed.)

Option 1

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Name: *

Primary Phone: *

Secondary Phone:

Address: *

City: *

State: *

Zip Code: *

Email:

Organization Name (affiliated congregation, farm, religious group, secular non-profit agency etc.): *

Type of organization? *

Community faith-based group (e.g. local church, mosque or synagogue or temple)

Regional or national faith-based institution

Farmer advocacy group supporting land access

Farmer or Gardener

Other:

If you are connected with or representing a faith group, please let us know affiliation with a national religious body (e.g. United Methodist Church or Union of Reform Judaism)? If yes, please list.

What scale of land are you involved with: e.g. acres you farm, acres you are responsible for managing.) *

< 1/2 acre

1/2 acre to 2 acres

2-10 acres

More than 10 acres

Has your group been involved with FaithLands or the Interfaith Sustainable Food Collaborative in the past? (Check all that apply)

Attended Roundtable

Attended Conference

Received a previous Grant/Mini-grant

Participated in Paicenes, CA Gathering in 2018

Other:

Why are you interested in attending the National Faithlands Gathering? What do you hope to gain from the gathering? *

What experiences or knowledge would you contribute to this gathering?

Are you working full-time in farming or work related to the National Faithlands Gathering?

Yes

Other:

Clear selection

Would you be interested in doing a presentation or serve as a panelist at the event for 15-30 minutes? If yes please describe topic. *

Have you already been invited to do a presentation or serve as a panelist?

Yes

Would you seek a full or partial scholarship?

Full

Partial

Other:

If you checked Partial above, indicate what financial assistance/scholarship pieces you are requesting. Check all that apply : *

Flight

Lodging

Meals and registration

Required

Is your participation dependent on the assistance/scholarship? (Could you still attend if not receiving your scholarship request?) *

Yes

Other:

What size budget does the organization/project/farm business you work with have? *

Less than $50,000

$50,000 - $249,999

$250,000-$499,999

$500,000-$999,999

Over a $1 million

Required

Race and Ethnicity

Asian

Black and/or African American

Indigenous/Original Peoples

Latino/a/x

Native Hawaiian and/or Pacific Islander

White

Prefer no to answer

Clear selection

Do you plan to participate in the full National Gathering if receiving travel assistance? (This would include tour 9 a.m. 8/25 until end of 2nd tour 1 p.m. 8/27)

Yes

Clear selection

How did you hear about the National Faithlands Gathering? *

Email from the Interfaith Sustainable Food Collaborative

Email from my religious group/institution

Direct outreach (phone call, word of mouth)

Required

Anything else reviewers should know?

Submit

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