Four subsidies will be available for the LifeLines Retreat. Preference will be given to active members of SCN. Please fill out the form below and submit it by December 1, 2010. The subsidy applications will be reviewed by January 1 and successful applicants notified by January 15.

Name:
Email Address:
Total family income:	less than $30,000 a year $30-40,000 $40-50,000
Tell us about your SCN activities (writing/reading circles, chapter work, etc.). If you are a member but not yet active, please describe the ways in which you intend to become involved with SCN:

Story Circle promises to keep your information confidential.

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What is the first letter of each word of this website's name (story circle network)? (enter your answer in all lowercase)