Scholarship Request Form

We believe in accessible support for every season of life.

Support should be within reach, even when money is tight. If you’re in a tough season, you’re not alone. You still deserve care, community, and the tools that can help you move forward.

Whether you're navigating burnout, employment challenges, family stress, or just feeling stretched thin, this is a space where you're met with compassion, not judgment.

Please take a moment to fill out the short form below. We offer partial and full scholarships based on need and availability. We’ll review your request as soon as possible and follow up via email with next steps. Please allow 5–7 business days for a response.

Name

First Name

Last Name

Email

Our Connection Groups currently meet on Tuesdays at 8:30 AM CT, Wednesdays at 12 PM CT, and Wednesdays at 5 PM CT. Do any of these times fit in to your schedule?

Yes

No

What services are you interested in?

Connection Groups

Online Community

Is there anything you'd like to share about your current situation or why you’re requesting support? (Please keep to 2-3 sentences)

How did you hear about Mom on the Spectrum?

We’re honored to support members of the community through all kinds of seasons. Your request will be held with care and confidentiality.

Scholarship Request Form

Mom on the Spectrum

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