Scholarship Request
* Required
Email address
*
Your email
Name
*
Your answer
Phone #, if you prefer text over email
Your answer
How will this membership affect your life?
*
Your answer
What do you think you can afford to pay per month, at this time?
Your answer
How did you hear about Divine Wellness Community?
*
Your answer
Would you like to contribute a skill or other offering to the community? Not required
Option 1
Clear selection
Are there any other ways we can support you?
Your answer
Submit
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