Scholarship Application Form

Personal Information

Full Name *

Email *

Country *

Professional Title & Registration (e.g., Clinical Psychologist, Licensed Therapist) *

1. How many years have you been practicing as a therapist/clinician? *

0-2 years

3-5 years

6-10 years

10+ years

2. What is your current work situation? *

Full-time private practice

Part-time private practice

Employed by an organization/institution

Not currently practicing

3. Which scholarship level are you applying for? *

25% discount (pay 75% of full price)

50% discount (pay 50% of full price)

4. Please briefly explain your current financial circumstances and why you're seeking scholarship support (2-3 sentences). *

5. Why do you want to join The Incubator? (100-150 words) *

6. What would creating a successful online program mean for you personally and professionally? *

7. Can you commit to participating in the weekly live coaching calls and engaging with the program content? *

Yes, I can commit to active participation

I'll do my best but have some time constraints

No, my schedule is too unpredictable

Optional: Is there anything else you'd like us to know about your situation?