Need Financial Support?

Are you in a cultic or abusive relationship and need support leaving? Please fill out the application below and we will be in contact with you.

Name

First Name

Last Name

Phone

(###)

###

####

Are You Leaving a Cult or an Abusive Relationship?

How did you hear about us?

Please Explain Your Situation and Your Needs

Do You Have Children Leaving With You?

Yes

If You Have Children How Many?