Counseling Scholarship Request

* Full Name (First and Last Only)

* Email Address

* Phone

* Address

* City

* State

* Zip Code

* Country

* 1st Counseling Language Preferred

2nd Counseling Language Preferred

* Preferred Counselor

* How Many Sessions Do You Need

* Sessions are $85 to $120 per hour based on counselor. What is the discount percentage you are seeking per session

Other counselor(s) preferred not listed

* How Many Scholarships Obtained By Us

* Explain your counseling need(s)

* Reasons for economic distress

* Family size

* Household monthly income

* Place of employment. We will not contact your employers. If not working, input "NA"

* Explain the industry and type of work you do

Additional Comments

Access and upload your most recent Tax Return Transcript.

If needed follow the IRS tutorials:

Written tutorial: https://short.gp.marketing/WqFMR

Video tutorial: https://short.gp.marketing/gGOxP

The file can be .jpg, .png, .gif, .pdf.

The tax form should show the previous year's filing information for your household submitted to the IRS and retrieved from the IRS website as instructed above. Thank you!

* Tax Form(s) Upload