Embody Your Goddess

Scholarship Application

* Please answer the questionnaire to be eligible for a scholarship

Name *

Email address *

Phone Number *

What interests you in the course? *

If weight loss is one of your goals, can you discuss where you are at now in reaching your goals? What have you tried? What is your weight loss goal(s)?

What do you hope to get out of this course? *

What financial burdens or complications are currently facing? *

Is there anything else you'd like to mention?

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