Healthy Sense of Self Grant Application

We believe that everyone has the right to a healthy and strong Sense of Self.

That's why we have created a grant to make our online course materials available to those who need financial support.

Simply fill out the application below and one of our program outreach facilitators will get back to you. Here's to your true Self!

First Name*
Last Name*
Email*
Phone Number (Include area code) +1-555-555-5555
Our outreach facilitator may call you regarding your application. Providing your phone number is not required but assists with scholarship assesment.
Which country do you live in?
Are you a parent?*
- Yes
- No
Please check which of the following you experience*
- Depression
- Anxiety
- Panic attacks
- Insomnia
- Self esteem / self worth issues
- A need to gain approval from others
- Other
Please explain why doing the Healthy Sense of Self course is important to you.*
Given your current financial circumstances, how much can you afford to pay for the Healthy Sense of Self Course?*
Please enter $ amount (must be greater than 0)
Thank you for completing the application. Is there anything else you would like to say?
Privacy*
- I've read and accept the Privacy Policy.

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