Safe Haven Coaching Scholarship Application Form

Safe Haven Coaching Scholarship

Application Form
Welcome!

At the heart of my coaching program is accessibility. It's crucial to me that nobody feels excluded due to financial constraints or fewer privileges. That's why I provide flexible payment plans and even offer partial scholarships for a select few eligible clients. If you're eager to embark on this transformative journey and fully committed to your personal growth, yet find yourself unable to afford it at this time, I encourage you to explore the option of applying for a scholarship. Please take a moment to fill out the application form below:
Your Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Format: (000) 000-0000.
Birthdate*

MonthDayYear
Date
Age*
Gender identity*
How did you hear about my coaching program?*
Background information
Are you currently working?*

YesNo
What's your occupation?*
Education Level*
If other, please specify:
Financial information
Annual Household Income*
If you reside in a country with a currency different from USD (United States Dollar), please ensure to convert your annual household income to USD for accurate reporting.
Currency Converter
Number of Dependents:*
If you're chosen for this scholarship, what amount are you comfortable setting aside each month for your personal transformation? You can select from the provided options or share your own preferred amount below:*

Less than $200$200 - $600$600 - $1K$1K or moreOther
If other, feel free to provide your specific amount. Your answer will help me evaluate your commitment and customize my support for you.
Rest assured, your financial details will be kept confidential.
Any exceptional financial burdens or circumstances you would like me to consider:
Application Essay: Motivation & Goals
Why apply? Please share why you are seeking a scholarship for my coaching program and how it aligns with your personal journey and aspirations*

0/300
Please share any challenging experience you've faced that has shaped your desire for personal transformation. How do you believe participating in this program will help you overcome such challenges? *

0/300
Describe any personal goals you aspire to achieve through participating in my coaching program:*

0/300
Terms and Conditions:

By submitting this application, you acknowledge that:
- The scholarship covers partial program fees and does not include additional benefits.
- Personal commitment and active participation are required throughout the duration of the program.
- Any information provided in this application may be used for scholarship selection purposes.
- Scholarship awards are subject to availability and the decision of the selection committee is final.
- The selection committee will review all applications and may take up to 5 business days to evaluate each case.
- You will be notified of the scholarship committee's decision via email or phone after the application review process is completed.
  Contact Information:
  
  For inquiries or assistance regarding the scholarship application process, please contact Cristhel Just at vcristhalito@gmail.com.
Declaration and Signature:

I certify that all information provided in this application is true and accurate to the best of my knowledge. I understand and agree to the terms and conditions outlined above.
Date*

MonthDayYear
Date
Scholarship Candidate Signature*
Should be Empty:

Safe Haven Coaching Scholarship

Welcome!

Background information

Financial information

Currency Converter

Application Essay: Motivation & Goals