FOR SOCIAL GOOD - IGNITE POWER SCHOLARSHIP FORM

FOR SOCIAL GOOD Presents the Scholarship Program For IGNITE POWER

Fill out the form to apply for a partial or full-ride scholarship to KeenAlignment's Ignite Power: Women's Leadership Retreat
Name

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
E-mail *
example@example.com
Phone Number *
Company *
When you look at yourself as a leader, what do you see? *
If there was nothing standing in your way, what would you be up to as a leader? *
What is your biggest block or challenge in pursuing your role as a leader? *
How do you plan to use this leadership training to help people in your community? *
Please share a little bit about your current projects, endeavors and/or business ventures (include websites or social media) and why they are important to you. *
Why do you believe at this time in your life you need a scholarship? *

Economic Distress High Stress Additional Burden of Responsibilities on a Personal Basis Job Loss
Scholarships are offered on a FULL or PARTIAL Basis. Tuition for the Retreat is $499. I would like to apply for a: *

Full Scholarship Partial Scholarship
For every three paid tuitions, we will donate one full scholarship. If you have the means to pay for partial tuition, that will allow us to spread our reach and include more powerful womxn. If you are applying for a Partial Scholarship, how much $$$ are you able to contribute towards tuition ($1 - $498)? *
Please share any of your social sites. (Optional)
Let's get EXCITED! Take a moment to share what you are most excited about for the retreat! (Optional)
Are there any additional comments, questions, constructive feedback, or information you'd like to share with us? (Optional)
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FOR SOCIAL GOOD Presents the Scholarship Program For IGNITE POWER