Energize! Couples Retreat Scholarship Application - Pocono Mountains, PA 2018
Partial scholarships are available for first-time attendees. The amount given will be dependent on your answers below.

Please wait to register for the retreat until you receive a reply to your scholarship application. If you apply for the scholarship by October 28th you are guaranteed the early bird price regardless of the outcome. 

All responses will be kept confidential and will only be seen by a few members of the BMP staff.

Email address *
You and your spouse's full names *
Your answer
Best phone number to reach you *
Your answer
What is your local community? *
Your answer
What financial circumstances prompted you to apply for this scholarship? (check all that apply to your couple) *
How much financial assistance do you need?
We have a limited amount for scholarships, and hope to provide a scholarship for as many couples as possible! Knowing this, please select an option below:
Briefly describe how receiving financial assistance to attend this retreat will benefit your couple. *
Your answer
Please briefly share what you hope to gain from this retreat! *
Your answer
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