Our goal is to help.

1

The goal of the Counseling Center at Seacoast is to help people find healing and wholeness. Due to the generosity of Seacoast Church, a scholarship may be available to ensure that finances are not a barrier to care. To request a scholarship, please answer the following questions.

2

Scholarship requests will be reviewed to determine how much financial assistance can be provided toward the standard hourly rate. A complete application, along with supporting documentation, must be submitted before a request can be reviewed. Please allow 7 business days for review. For your protection, all information is confidential. Scholarships are approved for 3 month terms and may be renewed with re-application.

3

Name* This field is required.

First Name

Last Name

4

Email* This field is required.

example@example.com

5

Please share why you are requesting financial assistance for counseling.* This field is required.

6

Do you attend a local church?* This field is required.

Yes

No

7

If yes, which church?

8

Where do you work? * This field is required.

9

What is your estimated monthly income? * This field is required.

10

What are your estimated monthly expenses? * This field is required.

11

Please attach one of the following: current pay stub with YTD income; or your last 2 months of bank statements (full bank statements, not screenshots).* This field is required.

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