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Personal Scholarship, for Western Wisconsin, St. Croix Valley Area
Complete this form if you are an
individual
looking for financial support and direction.
Contact Information
Name
First Name
Last Name
Email
Verify Email
Phone
Address
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
1. What studio location would you like to take yoga?
*
Healing Roots Wellness Center
Inspiring Actions Yoga
Not Sure
Other
2. Do you have a class, workshop or package in mind that you would want to take?
*
Yes
No
Not Sure
3. Are you able to contribute any amount of the cost? If so, how much is reasonable for you?
4. If no or not sure to question #2, please tell us about your interest in yoga.
4. Do you have any hopes or expectations that you'd like to share?