Foundations for Dating Scholarship Application

Please answer the following questions. No single question is an automatic in or out of our Foundations for Dating Web Workshop. We have limited spots for the Pilot Program and are simply working on a great mix of people.

Applications due by Tuesday, May 17 at 8a CT.

Are you dating someone right now?*

Yes
No

Have you developed your Ideal Mate Vision?*

Yes
No

Which of the following have you read or completed?*

The 5 Love Languages
Any book on Law of Attraction
Any Alison Armstrong material
Any Abraham Hicks material
Any John Gray material
DISC assessment
Values and rules hierarchy assessment
A Relationship Vision **in writing**
None of the above

What blockages have you noticed when it comes to dating or attracting your ideal mate?*

What triggers you when it comes to relationship? (ex: when a person that I am attracted to does or does not do X, it affects me in the following ways... Please list the trigger and the affect.)*

What beliefs about yourself surface when you think about or discuss being in a relationship?*

Why or how would this scholarship help you?*

What portion would you be able to contribute?*

Name*

First Last

Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

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