Scholarship Request for Our May Cohort
Thank you for your interest in HmntyCntrd (learn more at
www.hmntycntrd.com
)!
For students, laid off workers, anyone who doesn't have access to a professional development budget, or if your currency exchange rate is at an extreme difference with the US dollar (e.g. India, Brazil, etc) please fill out the form below to and someone on our team will get back to you on Monday April 26th to inform you if you have were selected for a limited number of discounts that we have available!
* Required
Your Full Name
*
Your answer
Your Email Address
*
Your answer
Where are you currently located?
*
Your answer
I identify as someone who:
*
Please select all that apply
Is a student
Was laid off or furloughed
Doesn't have access to a professional development budget from my employer
Has a currency exchange rate that is at an extreme difference with the US dollar
Is an underrepresented racial/ethnic minority
Has a disability
None of the above
Required
Most recent employer:
*
If you're a student, please write what school or program you are attending.
Your answer
If unemployed or furloughed, please write your last date of employment.
*
Write N/A if not applicable.
Your answer
I understand that my eligibility for this scholarship is conditioned on the accuracy of the information I have provided.
*
Write N/A if not applicable.
Yes
No
Submit
Never submit passwords through Google Forms.
This form was created inside of HmntyCntrd.
Report Abuse
Forms
