Scholarship App

First Name *

Last Name *

Phone *

Email *

Instagram Handle *

How would you best describe your current goals/challenges? (select all that apply) *

What is your commitment level to your personal results? *

I am extremely committed. I am sick of my own bs and I will do whatever it takes.

I'm committed enough to invest in my goals but I'm afraid of "missing out" on social events.

I know I need help to make a change but I'm not sure if I'm ready to fully commit.

Although the full scholarship(s) are set and limited, some partial scholarships may be given away as well. If you qualify, are you interested in hearing about this possible opportunity?

Yes, I am committed to achieving my goals and want to take advantage of any opportunity to make them happen.

I would love to hear about the details of the opportunity and talk about how I can make it work if the opportunity presents itself.

No, if it’s not free my goals aren’t worth it to me.

Scholarship Application