Application for RICH Conference Discount or Support
Street Address Line 2
State / Province
Postal / Zip Code
All entries are optional and this information is confidential. We ask only to prioritize applicants that identify as LGBTQIA+, people of color, as well as people who use drugs, people in recovery and people living with HIV for financial support.
What race do you identify as?
Do you identify as Transgender or non-binary?
Do you identify as LGBTQIA+
Are you a person living with HIV?
Do you identify as a person in recovery or a person who uses drugs?
Please describe how much of the registration you can afford? We primarily only provide partial scholarships.
Please describe if you do any work within the harm reduction or recovery community and what kind of work you do?
Please describe why you'd like or need financial support or a discounted registration?
Where will you be traveling from?
Do you need a hotel room? and if so how much financial support for the hotel room will be needed? (*Note all hotel rooms must be booked my March 5th, 2023 for our discounted block rate of 159/night plus tax and parking)
Should be Empty: