Partial Scholarship Application - Built To Influence Academy

Partial Scholarship Application - Built To Influence Academy
Serious applicants who are experiencing financial hardship may fill and submit this form in order to be considered for financial assistance for the membership fee. NOTE: All information below must be filled and submitted truthfully.

Student Information
First Name*
Enter one word without spaces
Last Name*
Enter one word without spaces
Email*
example@example.com
Instagram Handle*
Why do you need a partial scholarship? *
Why do you want to join Built To Influence? *
I want to be successful on Instagram. I am committed to the process. I will take the time to thoroughly digest all of the information presented in the academy. I will work hard to implement the strategies for success that are presented in the academy and will commit regular time to do so. I commit to having a complete ownership mentality for my success. I am ready to learn, work and win.*
Yes, I agree.
Signature*
Clear
DISCLOSURE AND AFFIRMATION
By submitting this form, I affirm that the information provided herein are true and correct to the best of my knowledge. Any false representation to any of the information I have disclosed may cause my disqualification to the program.
Today's Date*
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Date
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DISCLOSURE AND AFFIRMATION