Purify Your Gaze is dedicated to providing recovery support to all, regardless of financial ability.

As a result of donations provided by the generosity of those in the Muslim community we have been able to establish a limited scholarship fund in accordance to this philosophy.

We are looking for applicants who are energetic, resourceful, and have a positive attitude - please consider this and be thoughtful and thorough in your responses, and try your best to give us a good understanding of who you are and what this scholarship would mean to you if awarded.

To be considered for a scholarship you must complete this form and be willing to fulfill the to the agreed requirements of being an accepted participant in the Purify Your Gaze program.
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First Name *

Last Name *

Phone Number *

Marital Status *

Number Of Children

Country *

Birthdate *

Which of the following best describes you? *

Why are you not actively seeking work currently? *

What is your annual income? *

(please include your spouse's income if married)
How much income did you report for tax purposes this past year? *

(we may ask for a tax statement so please try to be accurate)
Are you financially supported by someone else, such as a parent or spouse? *

We have had members who have participated in our program by being financially sponsored by another family member (for example a parent or spouse). Have you asked or considered asking a family member if they would sponsor your participation in our program? *

The tuition for our 6 months Foundations Of Freedom program is $594 ($99 per month over 6 months).

Of that amount, how much are you able to afford each month?  (Prices are in US dollars) *

The Purify Your Gaze Program is delivered 100% virtually online and by phone. Regular participation requires your ability to have a reliable Internet connection and the ability to tune into weekly phone meetings.

Do you have the technical capability to participate in the program? *

What foreseeable complications or issues may prevent you from completing the program whether in terms of participation or following the recommendations given if you are awarded a Scholarship? *

Be as honest and thoughtful as possible in the section above. (Please note that any possible complications disclosed here will not necessarily disqualify you as a Scholarship candidate, but will help us customize your program)
If you could wave a magic wand and create an immense shift in your life, which one would you point your wand at?* *

What challenges are you experiencing with "{{answer_43930288}}", and how do you hope the Purify Your Gaze program will help you overcome these challenges? *

What proactive steps have you taken to improve your personal development and address your unwanted behaviors in the past 6 months to 1 year?

Why should we consider you for a scholarship? Please feel free to advocate for yourself. *

Please do not focus on your financial needs in this question. Rather, please tell us about what this scholarship means to you and what difference you hope to see by participating in our program.
Thank you for completing the scholarship application form.

We will be reviewing your application and will be in touch with you in the near future to discuss your application and to request follow up information.