Scholarship Application | Rumina Ubera

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Rumina Ubera

Where Lactation and Love Cultivate

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Need-Based Scholarship

First name

Last name

Email

Date of Birth

Race

Ethnicity

Gross Anual Income for Household

Hourly Wage (optional)

Place of Employment

Job Title

Which course or class would you like to take?

If 'All About Breastfeeding', which day would you prefer?

Are you on any government-assisted programs?

If yes to more than one government-assisted program, or 'other', please describe (optional)

Number of People in Household

*Rumina Ubera has a non-discrimination policy

Do not hesitate to email with any questions or concerns!

Rumina Ubera

ruminaubera@gmail.com

+1 (415) 722-1057

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