In accordance with Rose’s wishes, the Rose Caron Scholarship is a partial scholarship. Funds are made available based on qualifications, which is a combination of your financial concerns and history, goals and level of readiness to tackle your issues regarding health and healthy weight as presented below. Rose felt strongly that a key element for the success experienced by the women who come to Green Mountain was their willingness to make an investment in themselves, which attached a real “value” to their experience. Therefore, the women to whom we offer this scholarship are women willing to invest in themselves on every level (emotional, time away from home, some financial commitment).

Applicant Information

Name:

Address:

Ph:

Cell:

E-Mail Address:

Preferred Method of Contact:

Date of Birth:

SS#:

Occupation:

How Long at Current Employer:

Annual Income:

(We also need previous year income verification.)

Please tell us a little about yourself …

How did your current relationship with food develop?

Where are you now physically? Describe any medical issues you may have.

What would you like to accomplish by participating in our program and in becoming a healthier person?

Why should you be selected to receive the Rose Caron Scholarship?