New Republic of the Heart Community Scholarship Application Question Title * 1. Your Contact Information Name Address Address 2 City/Town State/Province ZIP/Postal Code Country Email Address Phone Number OK Question Title * 2. Your Age OK Question Title * 3. Occupation (or former occupation if retired) OK Question Title * 4. Your Living Situation Live alone Live with a roommate Live with a partner Rent home/apartment Own home/condo Other than rent/own Other (please specify) OK Question Title * 5. Please share a few words about why you want to participate in this social experiment? OK Question Title * 6. Please share a little bit about your history of personal, psychological and/or spiritual growth work. OK Question Title * 7. Please share a few words about your history as a change-agent, including service, charity, activism and social entrepreneurship. OK Question Title * 8. Describe why your financial situation makes the scholarship necessary and appropriate. OK Question Title * 9. As we engage in mutual generosity, what is the amount you are offering to contribute on a monthly basis? OK Question Title * 10. Would you like to offer to contribute anything else? (Volunteer services, etc.) OK DONE