Therapy Services Application — Half Full Institute

Name

First Name

Last Name

Email Address

Are you a resident of New York City?

We are currently only considering applicants within the 5 boroughs of New York City.

Yes

What services are you interested in?

Choose only those for which you are applying yourself or for another.

Individual Therapy

Group Therapy

Family Therapy

Question 1

In 500 words or less, explain why you or someone you are applying for needs this grant of services.

Question 2

In 500 words or less, describe why you or the person you are applying for is the best candidate for these services.

Question 3

In 500 words or less, describe your future plans. How will these free services help you or the person you are applying for continue toward achieving your/their goals?