Scholarship Application Form

Apply for a Scholarship

Thank you for your interest in taking an Eat Breathe Thrive course. We are pleased to offer a limited number of scholarships for our courses. Scholarship applicants will be informed of their scholarship award by email.

ABOUT YOU
Name:*

First NameLast Name
E-mail:*
example@example.com
Phone Number:*

Area CodePhone Number
Where in the world will you be joining us from?*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Inclusivity Matters

The following section informs our efforts to promote diversity, inclusivity, and accessibility. All questions in this section are optional. Our scholarship program seeks to support access and inclusion for individuals often under-represented at our courses — including men, non cis-gender folks, and people of color.
Please specify your preferred gender identity:

MaleFemaleGenderqueerIntersexTransgenderI prefer not to sayOther
Please specify your sexual orientation:

StraightGayLesbianBisexualAsexualQueerI'd prefer not to sayOther
Please specify your age:
Please specify your ethnicity:*

Non-Hispanic White or Euro-AmericanBlack, Afro-Caribbean, African American, or African EuropeanLatino, Hispanic American, or Hispanic EuropeanEast Asian, Asian American, or Asian EuropeanSouth Asian, Indian American, or Indian EuropeanMiddle Eastern, Arab American, or Arab EuropeanNative American or Alaskan NativeI'd prefer not to sayOther
Course Details
Which course do you wish to participate in? *
What is the name of the course facilitator?*

Becka WorthingtonChelsea RoffConnie-Jane LovellDaneen FarrallDixie BrownElyse AdelsonEmily PaigeGeorgiana SunleyHayley GuinnessKellie ZundelKelly WhiteLara ScribaLaurel CarterLindsey HinthorneMarissa PerrottaMeike PetermannMelanie TaylorMichelle McElroyNancy CunninghamNatalie MurphyNicole SchnackenbergRebecca StephensSamantha OsborneShannon TurnerI don't knowOther
To be considered for the Eat Breathe Thrive Facilitator Training, you must be a helping professional and you will need to have completed the Eat Breathe Thrive Immersion. Full information regarding the admission requirements can be found here.
Please check this box to indicate that you have read and meet the admission requirements and prerequisites for the Facilitator Training.
Why do you want to participate in this course? *
Are you interested in pursuing the Eat Breathe Thrive Facilitator Training?

YesNoI don't know
How soon are you able to begin the training?

I can begin immediately!Within 1-3 monthsWithin 3-6 monthsWithin 6-9 monthsMore than 9 months from now
NEEDS AND IMPACT
What is your income level?

Less than $15,000/year$15,000–$30,000/year$30,000–$50,000/year$50,000–$75,000/year$75,000–$100,000/yearOver $100,000/yearI’d prefer not to say
What is your income level?

Less than £15,000/year£15,000–£30,000/year£30,000–£50,000/year£50,000–£75,000/year£75,000–£100,000/yearOver £100,000/yearI’d prefer not to say
What is your income level?

Less than €15,000/year€15,000–€30,000/year€30,000–€50,000/year€50,000–€75,000/year€75,000–€100,000/yearOver €100,000/yearI’d prefer not to say
Why are you applying for a scholarship?*

Financial hardshipUnemployment/underemploymentUnpaid care of loved oneSingle-parent incomeOther
Are you currently employed?

YesNo
Tell us more about what you do for work.
Please provide details about your financial needs and / or circumstances.*
Do you work in any of the following professional fields? (Please tick all which apply.)*

Mental HealthcareMedical HealthcareComplementary Healthcare (includes yoga)EducationNone of the aboveOther
Do you currently volunteer with in-need or under-resourced populations?

YesNo
Please tell us about the population you serve.
How do you perceive this course will help you serve this population?
Are you planning to use this course to serve in-need or under-resourced populations? If so, how?
Is there anything else we should know about your situation? Please use the space below to share anything else you'd like us to consider.
Please use the space below to share anything else you'd like us to consider.
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Apply for a Scholarship

ABOUT YOU

Inclusivity Matters

Course Details

NEEDS AND IMPACT