Cynergy Training Scholarship Fund "*" indicates required fields Name* First Last Address* Street Address Address Line 2 City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Email* Enter Email Confirm Email Phone*Scholarship Requirements*Cynergy Training Scholarship funds are limited and will be awarded based on availability and need. Financial assistance is awarded on a month-to-month basis and is not to exceed three months in one calendar year. Awardee must re-apply before the end of the month if financial assistance is still necessary. Awardee must commit to attending a minimum of 10 classes during the month that assistance is awarded. I agree to the scholarship requirements.Start Date* MM slash DD slash YYYY Current Situation*Please describe your current situation and how it contributes to your financial hardship: Situation Term*Do you expect this to be a temporary or permanent situation? Temporary Permanent Other ExplainPlease elaborate on your response, if necessary.Membership*Please describe the importance of continuing your membership at Cynergy Training: Level of Assistance*The Cynergy Training Scholarship Program is funded by contributions from our individual members. These funds are limited. With that in mind, what level of assistance are you in need of? 25% 50% 75% 100% Other Pay it Forward*What are you willing to do to help “pay it forward” to our members and community? Select all that apply. Refer new members Write a review Share your experience on social media Other Select AllOther*Please explain:Additional Comments Δ
