Name *

First Name

Last Name

Which of these live experiences or identities do you feel represents you?

Select all that apply: I ask these questions not for you to gain points or lose points to receive a scholarship based on who you are. It is more for me to understand where the need for scholarships are so that I can begin to build stronger foundations to support communities that deserve to thrive in the wellness world. Choosing not to check any box does not affect your application. You can choose to leave them blank if that feels the best for you! -Monia

BIPOC

Trans

QTBIPOC

Queer

Paid Minimum Wage

Diagnosed/Seeking Mental or Chronic Illness

Disabled

Dynamic Disabilites

Access to Limited Resources

PTSD/C-PSTD Diagnosis or Seeking Diagnosis

Grad Student

What type of scholarship would you like to apply to? *

Full

Partial 50% off

Partial 25% off